培门冬酰胺酶致血、尿淀粉酶升高1例分析及药学监护  

Analysis and Pharmaceutical Care of Elevation of Amylase in Both Serum and Urine after Receiving Polyethylene Glycol Conjugated Asparaginase

作　　者：谢娟[1] 张永[2] 

机构地区：[1]南京医科大学附属妇产医院,江苏南京210004 [2]南京医科大学附属儿童医院,江苏南京210008

出　　处：《儿科药学杂志》2017年第6期42-44,共3页Journal of Pediatric Pharmacy

基　　金：2014年南京市医学科技发展计划;编号YKK14112

摘　　要：目的:探讨门冬酰胺酶相关性胰腺炎的发病风险及干预手段,提高医务人员对门冬酰胺酶相关性胰腺炎的认识,探讨临床药师该如何加强对培门冬酰胺酶用药的药学监护。方法:对1例急性淋巴细胞白血病患儿使用培门冬酰胺酶化疗后出现腹痛伴血、尿淀粉酶升高进行分析,并复习相关文献。结果:患儿使用培门冬酰胺酶化疗后出现腹痛伴血、尿淀粉酶升高,但无影像学异常表现,依据不良事件通用术语标准为1~2级门冬酰胺酶相关性胰腺炎,予禁食等对症处理后,显著好转。通过复习相关文献,评估患儿情况,认为可行第二剂培门冬酰胺酶化疗,临床药师对患儿进行饮食指导,在严密监护下行第二剂门冬酰胺酶化疗,患儿未出现类似不良反应。结论:临床药师需加强对使用培门冬酰胺酶化疗患儿的药学监护,对患儿及家属行用药教育,如出现门冬酰胺酶相关性胰腺炎不良反应时应及时评估,协同医师共同完成患儿化疗。Objective： To analyze the risk and intervene measures of asparaginase-associated pancreatitis （AAP）, in order to improve knowledge of medical staff to AAP, and to investigate how to strengthen the pharmaceutical care of polyethylene glycol conjugated asparaginase （PEG-ASP）. Methods： We reviewed medical records of a children whose amylase was elevated in serum and urine accompanied with abdominal pain after receiving PEG-ASP treatment and provide a review of the relevant literatures. Results： After received PEG-ASP treatment, the children had abdominal pain accompanied with elevation of amylase in both serum and urine, but without radiographic findings of pancreatitis. Utilizing the Common Terminology Criteria for Adverse Events, the children was identified as having grade 1 to 2 pancreatitis. After treatment, the children was recovered soon. The clinical pharmacist reviewed of the relevant literatures, assessed the situation of the children, given physician advice that the children can re-administration of PEG-ASP. Clinical pharmacists provide pharmacy services for children when the children re-administration of PEG-ASP, the children did not appear the similar reaction. Conclusion： Clinical pharmacist need to strengthen pharmaceutical care when children using PEG-ASP, if AAP is observed, physician and clinical pharmacist need to collaborate to complete treatment.

关 键 词：急性淋巴细胞白血病 门冬酰胺酶相关性胰腺炎 培门冬酰胺酶 

分 类 号：R725.7[医药卫生—儿科]