摘要
目的:比较左旋门冬酰胺酶和培门冬酶在儿童急性淋巴细胞白血病(ALL)延迟强化治疗中的不良反应,为临床合理用药提供参考.方法:收集并分析2010年1月至2015年4月本院儿科收治的ALL患儿的临床资料.按延迟强化治疗中应用门冬酰胺酶制剂的不同分为左旋门冬酰胺酶组(L-Asp组)和培门冬酶组(PEG-Asp组).比较两组在治疗中血生化(ALT、TBil、DBil、TP、ALb、BUN)、凝血功能(PT、APTT、Fbg、TT)、过敏反应、胃肠道副反应(恶心、呕吐和/或腹痛)和平均住院时间.结果:延迟强化治疗后L-Asp组表现为ALT和TT值升高、TP和ALb值降低(P<0.05);PEG-Asp组表现为ALT、TBil、DBil、BUN、APTT、TT值升高,而TP、ALb、Fbg值降低(P<0.05);PEG-Asp组患儿TP、ALb值较L-Asp组患儿低,而ALT和BUN值较L-Asp组患儿高,具有明显统计学差异(P<0.05).两组患儿胃肠道副反应和平均住院时间相比无统计学差异(P>0.05).结论:左旋门冬酰胺酶和培门冬酶在儿童ALL延迟强化治疗中对肝功能及凝血功能均有影响,培门冬酶对ALT、TP、ALb值的影响更显著,且可引起BUN值的升高.两者均有腹痛等胃肠道副反应,但培门冬酶更易并发急性胰腺炎.
Objective:To compare the adverse reactions of L-asparaginase and PEG-asparaginase during intensive treatment in children with acute lymphocytic leukemia(ALL),and to provide a reference for use of the two drugs.Methods:To collect and analyze the clinical datas of children with ALL in pediatrics in our hospital from January 2010 to April 2015.According to the preparations of asparaginase used in delayed intensive therapy,they were divided into the L-asparaginase group(L-Asp group)and the PEG-asparaginase group(PEG-Asp group).Blood biochemical indexes(ALT,TBil,DBil,TP,ALb,BUN),coagulation index(PT,APTT,Fbg,TT),allergic reactions,gastrointestinal side reactions(nausea,vomiting and/or abdominal pain)and average treatment Length of hospitalization between the two groups were compared.Results:After intensive therapy,L-Asp group showed ALT and TT increased,but TP and ALb decreased(P<0.05);PEG-Asp group showed ALT,TBil,DBil,BUN,APTT,TT increased,but TP,ALb,Fbg decreased.TP and ALb in the PEG-Asp group were lower than those in the L-Asp group,while ALT and BUN were higher than those in the L-Asp group,there was a significant statistical difference between the two groups(P<0.05).There was no statistical difference of gastrointestinal side reactions and average length of hospitalization between the two groups(P>0.05).Conclusion:L-asparaginase and PEG-asparaginase have adverse impact on liver function and coagulation function during intensive therapy in children with ALL,and PEG-asparaginase has more significant adverse impact on ALT,TP,and ALb,and can cause BUN to increase.Both have abdominal pain and other gastrointestinal side reaction,but PEG-asparaginase is more likely to cause acute pancreatitis.
作者
占诗贵
张丽娜
黄正刚
张丽娟
ZHAN Shi-gui;ZHANG Li-na;HUANG Zheng-gang;ZHANG Li-juan(Department of Pediatrics,the Binhai Bay Central Hospital of Dongguan,Guangdong Dongguan 523000,China;Department of Pediatrics,the First Affiliated Hospital of Nanchang University,Jiangxi Nanchang 330006,China)
出处
《中国药物评价》
2020年第1期50-54,共5页
Chinese Journal of Drug Evaluation
基金
江西省教育厅青年科学基金(课题名称:两种不同剂型门冬酰胺酶在儿童急淋治疗中的比较,课题编号:14172)。
