儿童急性白血病化疗药物性肝损害的临床分析  

Clinical Analysis of Chemotherapy-induced Hepatic Impairment in Children with Acute Leukemia

作　　者：王菊平[1] 李小芹 李永春 Wang Juping;Li Xiaoqin;Li Yongchun(Children's Hospital Affiliated to Zhengzhou University,Henan Children's Hospital,Pharmacy Department of Zhengzhou Children's Hospital;Children's Hospital Affiliated to Zhengzhou University,Henan Children's Hospital,Gastroenterology Department of Zhengzhou Children's Hospital,Zhengzhou 450000 China)

机构地区：[1]郑州大学附属儿童医院、河南省儿童医院、郑州儿童医院药学部 [2]郑州大学附属儿童医院、河南省儿童医院、郑州儿童医院消化科,河南郑州450000

出　　处：《锦州医科大学学报》2020年第2期32-35,共4页Journal of Jinzhou Medical University

基　　金：2018年度河南省医学科技攻关计划(联合共建项目),项目编号:2018020643。

摘　　要：目的探讨儿童急性白血病化疗药物性肝损害危险因素。方法选择我院在2014年1月至2018年1月收治的206例儿童急性白血病临床病例进行回顾性分析。根据患儿是否出现肝损害将其分为两组,无肝损害的患儿为对照组175例,药物性肝损害患儿为观察组共31例。发生DILI病例数及转归情况进行统计整理,采集两组患儿一般资料:包括性别、年龄、BMI指数、药物过敏史、感染、输血、护肝药物的使用等资料。结果本次临床分析共纳入合格患儿206例,其中药物性肝损害发生31例,发生率为15.05%。单因素分析结果显示,儿童急性白血病化疗药物性肝损害与BMI指数、药物过敏、心血管疾病、感染、输血及护肝药物的使用有关(P<0.05)。多因素Logistic回归分析结果显示,BMI指数、心血管疾病、感染、输血及护肝药物为儿童急性白血病化疗药物性肝损害的独立性影响因素(P<0.05)。结论BMI指数、心血管疾病、感染、输血及护肝药物为儿童急性白血病化疗药物性肝损害的独立性影响因素,临床上应对上述因素进行干预,以减少儿童急性白血病化疗药物性肝损害的发生。Objective To analyze the clinical effects of chemotherapy-induced liver injury in children with acute leukemia,and explore its risk factors.Methods 206 children with acute leukemia admitted in our hospital from January 2014 to January 2018 were retrospectively analyzed and divided into two groups according to whether there was liver damage.175 children without liver damage were in the control group and 31 children with drug-induced liver damage were in the observation group.The number of DILI cases and their outcome were statistically analyzed and the general data of two groups were collected including gender,age,BMI index,history of drug allergy,infection,blood transfusion and the use of hepatoprotective drugs.Results In the clinical analysis,a total of 206 eligible children were enrolled,among whom 31 cases of drug-induced liver damage occurred,with a rate of 15.05%.Univariate analysis showed that drug-induced liver damage in children with acute leukemia was associated to BMI,drug allergy,cardiovascular disease,infection,blood transfusion and hepatoprotective drugs(P<0.05).Multivariate logistic regression analysis showed that BMI,cardiovascular disease,infection,blood transfusion,and liver protection drugs were independent influencing factors of hepatic impairment in children with acute leukemia(P<0.05).Conclusion BMI index,cardiovascular diseases,infections,blood transfusion and liver protection drugs are independent influencing factors of chemotherapy-induced hepatic impairment in children with acute leukemia.The above factors should be clinically intervened to reduce the incidence of chemotherapeutic liver damage in children with acute leukemia.

关 键 词：儿童 急性白血病 化疗 药物性肝损害 

分 类 号：R72[医药卫生—儿科]