左旋门冬酰胺酶及培门冬酶治疗小儿急性淋巴细胞白血病的疗效及实验室指标比较  

Comparison of Efficacy and Laboratory Indexes of L-Asparaginase and Pegasparpase in the Treatment of Children with Acute Lymphoblastic Leukemia

作　　者：赵学勤 王政委 庄艳 宋爱琴[3] Zhao Xueqin;Wang Zhengwei;Zhuang Yan;Song Aiqin(Qingdao Uniersty,Shandong Qingdao 266071,China;Linyi raditioral Chinese Medicine Hospial,Shandong Linyi 276000,China;The Afjliated Hopital of Qingdao Univesity,Shandong Qingdoo 266555,China)

机构地区：[1]青岛大学,山东青岛266071 [2]临沂市中医医院,山东临沂276000 [3]青岛大学附属医院,山东青岛266555

出　　处：《儿科药学杂志》2020年第10期17-20,共4页Journal of Pediatric Pharmacy

摘　　要：目的:观察左旋门冬酰胺酶(L-Asp)及培门冬酶(PEG-Asp)两种方案治疗小儿急性淋巴细胞白血病的临床疗效。方法:选取2017年5月至2018年8月临沂市中医医院收治的103例小儿急性淋巴细胞白血病患儿作为研究对象,回顾性分析所有患儿临床及随访资料,按照用药情况分为左旋门冬酰胺酶组(L组,51例)及培门冬酶组(P组,52例),L组使用L-Asp每次6 000U/m2,静脉注射,P组使用PEG-Asp每次2 500 IU/m2,肌肉注射,比较两组患儿治疗疗效、住院时间、治疗后凝血功能障碍、肝功能情况及不良反应。结果:两组患儿治疗期间丙氨酸氨基转移酶水平呈上升趋势(P<0. 01),P组患儿治疗期间均低于L组患儿(P<0. 05);两组患儿治疗期间白蛋白水平呈下降趋势(P<0. 05);两组患儿治疗期间总胆红素水平呈上升趋势(P<0. 05);治疗后L组患儿过敏反应及胰腺炎发生率高于P组(P<0. 05)。结论:PEG-Asp治疗小儿急性淋巴细胞白血病能更快缓解患儿病情,用药次数少、住院时间短,过敏反应发生率低于L-Asp,但胰腺炎发生率却高于L-Asp,所以有关PEG-Asp的安全性还应进行进一步深入研究探讨。Objective: To observe the clinical efficacy of L-asparaginase( L-Asp) and pegaspargase( PEG-Asp) in the treatment of children with acute lymphoblastic leukemia. Methods: Totally 103 children with acute lymphoblastic leukemia admitted into Linyi Traditional Chinese Medicine Hospital from May 2017 to Aug. 2018 were extracted,the clinical and follow-up data of all children were analyzed retrospectively. According to different treatment drugs,all children were divided into the L-asparaginase group( group L,51 cases) and the pegasparpase group( group P,52 cases). Group L was treated with L-Asp every 6,000 U/m2 intravenous injection,group P received PEG-Asp every 2,500 IU/m2 intramuscular injection. Efficacy,length of stay,coagulation dysfunction,liver function and adverse drug reactions after treatment of two groups were compared. Results: The level of alanine aminotransferase showed an increasing trend in both groups( P<0. 01),while the level of alanine aminotransferase in group P was lower than that in group L( P<0. 05). The level of albumin in two groups showed a downward trend( P< 0. 05). The level of total bilirubin in both groups showed an upward trend( P<0. 05). After treatment,the incidence of allergic reaction and pancreatitis in group L was higher than that in group P( P<0. 05). Conclusion: PEG-Asp in the treatment of children with acute lymphoblastic leukemia can relieve the disease of children quickly,with fewer times of administration,shorter length of stay and lower incidence of allergic reaction than L-Asp,but higher incidence of pancreatitis than L-Asp,and the safety of PEG-Asp should be further studied and discussed.

关 键 词：左旋门冬酰胺酶 培门冬酶 小儿 急性淋巴细胞白血病 临床指标 

分 类 号：R725.5[医药卫生—儿科]