乙二醇化门冬酰胺酶治疗成人急性淋巴细胞白血病对患者凝血功能的影响  

The influence of polyethylene glycol conjugated asparaginase on coagulation function in adult patients with acute lymphoblastic leukemia

作　　者：陈静[1] CHEN Jing(Department of Hematology,The First People's Hospital of Tianmen City,Tianmen 431700,Hubei Province,China)

机构地区：[1]湖北省天门市第一人民医院血液科,湖北天门431700

出　　处：《世界临床药物》2020年第4期282-287,共6页World Clinical Drug

摘　　要：目的探讨乙二醇化门冬酰胺酶治疗成人急性淋巴细胞白血病(acute lymphocytic leukemia,ALL)对凝血功能的影响。方法选取于2017年2月至2018年2月我院收治的60例成人ALL患者,使用随机数字表法分为对照组和观察组,每组30例。对照组在化疗基础上加用左旋门冬酰胺酶,观察组则加用乙二醇化门冬酰胺酶。对比两组近期疗效、远期疗效及凝血功能指标变化。结果观察组近期疗效临床治愈率高于对照组(86.67%对73.33%,P<0.05),两组无进展生存期曲线、总生存期曲线差异无统计学意义(P>0.05)。与治疗前相比,两组接受治疗后的活化部分凝血活酶时间(activated partial thromboplastin time,APTT)水平明显升高,血浆纤维蛋白原(plasma fibrinogen,FIB)水平降低(P<0.05),血小板(blood platelet,PLT)水平、凝血酶原时间(prothrombin time,PT)及凝血酶时间(thrombin time,TT)无明显变化(P>0.05)。而两组治疗后的PLT、PT、APTT、TT及FIB水平接近(P>0.05)。观察组的肝功能损害、胃肠道反应及APTT延长发生率明显更低(P<0.05)。结论在成人ALL的临床治疗中,应用乙二醇化门冬酰胺酶可有效提高近期疗效,减轻化疗药物引起的胃肠道反应及肝功能损害,同时还能降低凝血功能异常发生的风险。Objective To investigate the influence of polyethylene glycol conjugated asparaginase(PEG-asp)on coagulation function in treating adult patients with acute lymphoblastic leukemia(ALL).Methods Sixty cases of adult ALL patients were divided into control group and observation group by random number table,30 cases in each group.On the basis of chemotherapy,L-asparaginase(L-asp)was added in the control group and PEG-asp was added in the observation group.The short-term effect,long-term effect and changes of coagulation function were compared between the two groups.Results The short-term curative effect of the observation group was higher than that of the control group(86.67%vs 73.33%,P<0.05).There was no significant difference in progression free survival curve and overall survival curve between the two groups(P>0.05).Compared with that before treatment,activated partial thromboplastin time(APTT)level significantly rose and plasma fibrinogen(FIB)level significantly reduced in the two groups(P<0.05).Blood platelet(PLT),prothrombin time(PT)and thrombin time(TT)levels had no significant change(P>0.05).There was no significant difference in the levels of PLT,PT,APTT,TT and FIB between the two groups after treatment(P>0.05).The incidence of liver function damage,gastrointestinal reaction and APTT prolongation in the observation group was significantly lower than that in the control group(P<0.05).Conclusion For clinical treatment of adult ALL,PEG-asp can improve the short-term curative effect,reduce gastrointestinal reaction,liver function damage and the risk of coagulation dysfunction.

关 键 词：乙二醇化门冬酰胺酶 急性淋巴细胞白血病 凝血功能 左旋门冬酰胺酶 

分 类 号：R551.3[医药卫生—血液循环系统疾病]