急性淋巴细胞白血病患儿化疗期间营养状况分析  

Analysis of the nutritional status in pediatric ALL patients during therapies for remission induction with L-asp

作　　者：张晓艳 陆箴琦[2] 沈树红[1] 沈南平[3] 陆红[3] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心血液肿瘤科,200127 [2]复旦大学附属肿瘤医院护理部 [3]上海交通大学医学院附属上海儿童医学中心护理部,200127

出　　处：《中国护理管理》2015年第11期1327-1330,共4页Chinese Nursing Management

基　　金：上海儿童医学中心-雅培/世界健康基金会临床营养发展中心科研项目

摘　　要：目的 :了解急性淋巴细胞白血病(ALL)患儿诱导缓解期使用左旋门冬酰胺酶(L-asp)的营养状况变化情况。方法:收集2014年7月至2015年4月在上海儿童医学中心确诊急性淋巴细胞白血病并使用左旋门冬酰胺酶进行诱导缓解治疗的49例患儿的临床资料,从L-asp化疗开始前1天至L-asp化疗结束每周1次收集实验室指标和人体学测量指标,人体组分仪器测量时间点分别为L-asp化疗开始前1天和L-asp化疗结束日,并记录患儿性别、年龄、疾病危险度、有无使用人血白蛋白。结果 :ALL患儿诱导缓解L-asp使用期间上臂围减小(P<0.01),三角肌皮褶厚度增大(P<0.01),差异均有统计学意义;患儿L-asp使用期间去脂体质量和肌肉量均下降(P<0.01),血清白蛋白呈进行性下降,差异有统计学意义(P<0.01)。结论 :急性淋巴细胞白血病患儿诱导缓解L-asp使用期间患儿存在不同程度的低蛋白血症,瘦体组织消耗增多,应尽早给予营养支持,以期改善患儿营养状况。Objective： To investigate the changes of nutritional status in pediatric Acute Lymphoblastic Leukemia （ALL） patients during therapies for remission induction with L-asparaginase （L-asp）. Methods： Prospectively collected a total of 49 pediatric patients diagnosed with ALL and undergoing therapies for remission induction with L-asparaginase in Shanghai Children＇s Medical Center from July 2014 to April 2015. Recording laboratory index and anthropometric measurements once a week during the period of using L-asp. Measuring the body composition on the day before using L-asp and on the final day of using L-asp. The gender, age, the risk of the disease, and if using human serum albumin were also recorded. Results： During the therapies for remission induction with L-asp in pediatric ALL patients, the mid-upper arm circumference decreased significantly （P〈0.01） and the triceps skinfold increased significantly （P〈0.01）. The differences were statistically significant. Meanwhile, the fat-free body weight and the muscle mass decreased significantly （P〈0.01）. The serum albumin decreased significantly （P〈0.01）. The differences were statistically significant. Conclusions： These pediatric ALL patients had different degrees of hypoproteinemia and had fat-free mass loss during the therapies for remission induction with L-asp. They need nutrition support at the beginning of the therapy to get a better nutritional status.

关 键 词：急性淋巴细胞白血病 诱导缓解 左旋门冬酰胺酶 儿童 人体学测量 

分 类 号：R47[医药卫生—护理学]