培门冬酶与门冬酰胺酶对儿童急性淋巴细胞白血病诱导缓解治疗中凝血功能的影响  

Effects of pegaspargase and L-asparaginase on coagulation function of children with acute lymphoblastic leukemia during remission induction

作　　者：王西阁[1] 郭怡丹[1] 赵雪莲[1] 任瑞芳[1] WANG Xi-ge;GUO Yi-Dan;ZHAO Xue-Lian;Ren Rui-fang(Department of Pediatrics,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)

机构地区：[1]郑州大学第三附属医院儿内科,河南郑州450052

出　　处：《实用医药杂志》2018年第1期18-20,23,共4页Practical Journal of Medicine & Pharmacy

摘　　要：目的比较培门冬酶(pegaspargase,PEG-Asp)和左旋门冬酰胺酶(L-asparaginase,L-Asp)对急性淋巴细胞白血病(acute lymphocytic leukemia,ALL)儿童患者凝血功能的影响,为ALL儿童患者化疗方案的选择提供依据,同时对应用二者过程中及时监测凝血功能及采取适当措施提供指导。方法回顾性收集2014年1月—2016年12月小儿血液科收治的分别采用PEG-Asp或L-Asp行诱导缓解方案的81例ALL儿童患者(PEG-Asp组和L-Asp组)的临床资料并进行分析。诱导缓解治疗第33天骨髓象检查结果显示两组儿童患者均处于完全缓解状态。结果 PEG-Asp组纤维蛋白原(FIB)降低50例次,活化的部分凝血活酶时间(APTT)延长19例次,凝血酶原时间(PT)延长5例次,凝血酶时间(TT)延长4例次,国际标准化比值(INR)升高者为0例次,L-Asp组纤维蛋白原(FIB)降低25例次,活化的部分凝血活酶时间(APTT)延长2例次,凝血酶原时间(PT)延长0例次,凝血酶时间(TT)延长0例次,国际标准化比值(INR)升高者为0例次。结论培门冬酶与左旋门冬酰胺酶对ALL儿童患者凝血功能影响主要表现为不同程度的FIB下降及APTT延长,且二者对凝血功能的影响有统计学差异。Objective To compare the effects of pegaspargase(PEG-Asp)and L-asparaginase(L-Asp)on their coagulation function in children with acute lymphocytic leukemia(ALL)so as to provide the basis for chemotherapy regime's choice of ALL and the guidance for timely monitoring coagulation function and taking appropriate measures in application of both.Methods The clinical data of 81 patients with ALL(PEG-Asp group and L-Asp group)received PEG-Asp or L-Asp-induced mitigation regimen were collected from January 2014 to December 2016 in pediatric hematology dept.and retrospectively analysed;on the 33th day of induction remission bone marrow examination results showed that two groups were in a complete state of remission.Results The fibrinogen(FIB)of PEG-Asp group was decreased in 50 case-times,the activated partial thromboplastin time(APTT)was prolonged in 19 case-times,the prothrombin time(PT)was prolonged in 5 case-time,and the thrombin time(TT)(FIB)decreased in 25 case-times,the activation of partial thromboplastin time(APTT)was prolonged in 2 case-times,and the thrombin was increased in the L-Asp group(P<0.05)(PT)prolonged in 0 case-times,thrombin time(TT)prolonged in 0 case-times,and the international standardized ratio(INR)increased in 0 case-times.Conclusion The effect of PEG-Asp and L-Asp on coagulation in children with ALL is mainly manifested at different degrees of FIB decline and prolongation of APTT,and the effect of both on the coagulation function has statistically difference.

关 键 词：急性淋巴细胞白血病 培门冬酶 门冬酰胺酶 凝血功能 儿童 

分 类 号：R725.5[医药卫生—儿科] R733.7[医药卫生—临床医学]