小百肽营养配方粉在急性淋巴细胞白血病患儿营养支持中的有效性和安全性分析  

Efficacy and safety of Peptamen Junior in the nutritional support for children with acute lymphoblastic leukemia

作　　者：李欣瑜[1] 翁文骏[1] 王静文[1] 韩黠蔚 许吕宏[1] 徐宏贵[1] 黄科[1] 周敦华[1] 黎阳[1] 方建培[1] LI Xin-yu;WENG Wen-jun;WANG Jing-wen;FANG Jian-pei(Department of Pediatrics,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院儿科,广东广州510120

出　　处：《中国实用儿科杂志》2020年第2期120-125,146,共7页Chinese Journal of Practical Pediatrics

基　　金：国家自然科学基金面上项目(81570140);广州市科技计划项目(201803010032);广东省自然科学基金项目(2018A030313526);中山大学临床医学5010项目(2007016)。

摘　　要：目的评价化疗期间急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)患儿使用小百肽营养配方粉(简称小百肽)在营养支持方面的有效性及安全性。方法对中山大学孙逸仙纪念医院儿科2015年6月至2017年12月88例确诊急性淋巴细胞白血病患儿行随机对照研究。受试者分配到治疗组及对照组,治疗组接受标准剂量小百肽营养干预,两组均同时诱导缓解化疗。观察两组在营养评价指标及化疗不良反应的差异。结果88例患儿平均年龄别体重Z值-1 SD^-2 SD 21例(23.86%),-2 SD以下6例(6.82%)。化疗结束,治疗组低钠血症(P=0.03)、低钙血症(P=0.047)发生率显著低于对照组,血清总蛋白水平高于对照组(P=0.046)。急性胰腺炎、凝血功能紊乱发生率差异无统计学意义。治疗组人血白蛋白平均输注量为21.57(16.02,27.10)g,对照组为34.59(26.33,42.86)g,P=0.011。治疗组患儿体重维持稳定,而对照组患儿体重为下降趋势。结论小百肽在ALL诱导缓解化疗中具有安全性。小百肽可维持患儿体重稳定,改善低白蛋白血症、低蛋白血症,减少人血白蛋白输注量,减少电解质紊乱的发生。Objective To evaluate the efficacy and safety of Peptamen Junior in nutritional support for acute lymphoblastic leukemia(ALL)children during chemotherapy. Methods A total of 88 cases of ALL admitted to Department of Pediatrics,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,from June 2015 to December 2017 were involed in the randomized control trial. Volunteers were included and assigned randomly into 2 groups(control group and treatment group). The treatment group received standard dose of Peptamen Junior for intervention;meanwhile,all of them will accept induction remission chemotherapy. The data on efficiency of nutrition intervention,adverse events,and remission rates were collected and studied.Results A total of 88 cases were analyzed,including 21 cases(23.86%)with Z-value of average weight for age being-1 SD--2 SD and 6 cases(6.82%)with Z-value being under-2 SD. At the end of chemotherapy,the incidence of hyponatremia(P=0.03)and hypocalcemia(P=0.047)in the treatment group was significantly lower than that in the control group,while the serum protein level was higher(P=0.046). There was no difference in the incidence of acute pancreatitis or coagulation disorders between two groups. The average amount of albumin transfusion was 21.57(16.02,27.10)g in the treatment group and 34.59(26.33,42.86)g in the control group(P=0.011). The weight of children in the treatment group was stable,while that of the control group was decreasing. Conclusion Peptamen Junior is safe in ALL induction remission chemotherapy.Peptamen Junior maintains the weight stability of children,alleviates hypoalbuminemia and hypoalbuminemia,and decreases the albumin infusion amount and the occurrence of electrolyte disorders.

关 键 词：儿童 急性淋巴细胞白血病 急性营养不良 化学治疗 营养支持 

分 类 号：R72[医药卫生—儿科]