左旋门冬酰胺酶两种用药方式治疗儿童淋巴系统恶性肿瘤的药代动力学研究  

Comparative pharmacokinetic study of two different ways of using L asparaginase as the main drug in combination chemotherapy

作　　者：王耀平[1] 蒋慧[2] 谢晓恬 杜玲珍[4] 陆正华[2] 王耀莉[4] 

机构地区：[1]上海第二医科大学附属上海儿童医学中心,200092 [2]上海市儿童医院 [3]上海铁道医科大学附属甘泉医院 [4]上海第二医科大学附属瑞金医院

出　　处：《中华血液学杂志》1999年第11期589-591,共3页Chinese Journal of Hematology

摘　　要：目的　通过对２０ 例恶性淋巴系统肿瘤患儿的治疗，探索左旋门冬酰胺酶（ＬＡＳＰ） 安全、有效的用药方式，指导临床治疗。方法　将２０ 例患儿随机分为每天用药组及隔天用药组，两组均用８次ＬＡＳＰ，每次６０００ ＫＵ／ｍ２（１ ＫＵ＝１ＩＵ） 静脉滴注，每次用药前检测血清中ＬＡＳＰ活性及其底物门冬酰胺水平，以比较两种用药方法的差异性，并观察其不良反应之差异。结果　每天用药组血清中ＬＡＳＰ谷值水平明显高于隔天用药组（Ｐ＜０ ．０１） ；两组门冬酰胺最低浓度的平均水平及分布情况差距不大（ Ｐ＞０ ．０５） ；每天用药组消化道反应、血清清蛋白水平下降及ＡＬＴ（ＧＰＴ） 升高的发生率明显高于隔天组（ Ｐ＜０ ．０５）。结论　隔天每次ＬＡＳＰ６０００ ＫＵ／ｍ２ 静脉滴注为安全。Objective To search for a safer and more effective way of using L asparaginase as the main drug in combination protocol. Method Twenty children with lymphoid malignancies were randomly divided into two groups: Group A and Group B, for L asparaginase therapy. Group A: Leunase 6?000?KU/m 2,continuous intravenous injection every day for 8 times;Group B:Leunase 6?000?KU/m 2 ,continuous intravenous injection every other day for 8 times. Blood samples were collected every day for group A and every other day for group B and serum L asparaginase and L asparagine levels were tested. Results ①The pre treatment mean value of serum L asparaginase in group A was significantly higher than that in group B (P<0.01).The levels of L asparaginase in group A tended to increase day by day during the therapeutic course while those in group B without increasing tendency. ②The L asparagine levels and their dynamic changes were not significantly different between the two groups (P>0.05).Conclusion The administration of Leunase by continuous intravenous injection every other day is a much safer and effective protocol and worthy of recommendation.

关 键 词：天冬酰胺酶 药代动力学 淋巴系肿瘤 药物疗法 

分 类 号：R733.05[医药卫生—肿瘤] R979.1[医药卫生—临床医学]