VDPAP方案对急性淋巴细胞白血病患儿凝血功能及血常规指标的影响  

Effect of VDPAP program on coagulation function and routine blood indicators in children with acute lymphoblastic leukemia

作　　者：李敖龙 王铁锋[2] 张琪[2] LI Aolong;WANG Tiefeng;ZHANG Qi(Department of Pediatrics,Zhoukou Central Hospital,Zhoukou 466000,He’nan,China;Neonatal Intensive Care Unit,Zhoukou Central Hospital,Zhoukou 466000,He’nan,China)

机构地区：[1]周口市中心医院儿科,河南周口466000 [2]周口市中心医院新生儿重症监护室,河南周口466000

出　　处：《癌症进展》2023年第19期2193-2196,2200,共5页Oncology Progress

摘　　要：目的探讨泼尼松+培门冬酶+长春新碱+柔红霉素(VDPAP)方案对急性淋巴细胞白血病(ALL)患儿凝血功能及血常规指标的影响。方法依据治疗方法的不同将98例ALL患儿分为对照组和观察组,每组49例,对照组患儿给予泼尼松+左旋门冬酰胺酶+长春新碱+柔红霉素(ADLP)方案化疗,观察组患儿给予VDPAP方案化疗。比较两组患儿的临床疗效、凝血功能指标[活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶原时间(PT)]、血常规指标[血小板计数、红细胞计数、血红蛋白(Hb)]、炎症因子指标[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)]、不良反应发生情况及复发情况。结果观察组患儿的治疗总有效率为93.88%,与对照组患儿的89.80%比较,差异无统计学意义(P﹥0.05)。治疗后,两组患儿APTT、PT均长于本组治疗前组,FIB、hsCRP、IL-6水平均低于本组治疗前,血小板计数、红细胞计数、Hb水平均高于本组治疗前,观察组患儿APTT、PT均长于对照组,FIB、hs-CRP、IL-6水平均低于对照组,血小板计数、红细胞计数、Hb水平均高于对照组,差异均有统计学意义(P﹤0.05)。观察组患儿末梢神经炎、过敏反应发生率均低于对照组,差异均有统计学意义(P﹤0.05)。观察组患儿6个月复发率为2.04%,低于对照组患儿的20.41%,差异有统计学意义(P﹤0.05)。结论VDPAP方案与ADLP方案均可提高ALL患儿的总有效率,其中VDPAP方案可有效降低ALL患儿血清IL-6等炎症因子水平,提高血小板计数,降低末梢神经炎等不良反应发生率及复发率,但可能会引起凝血功能异常,临床需重点关注。Objective To investigate the effect of prednisone+pegaspargase+vincristine+daunorubicin(VDPAP)regimen on coagulation function and routine blood indicators in children with acute lymphoblastic leukemia(ALL).Method A total of 98 children with ALL were divided into control group and observation group based on different treatment methods,with 49 cases in each group.Children in the control group were given chemotherapy with the L-asparaginase+prednisone+vincristine+daunorubicin(ADLP)regimen,while children in the observation group were given chemotherapy with the VDPAP regimen.The clinical efficacy,coagulation function indicators[activited partial thromboplastin time(APTT),fibrinogen(FIB),prothrombin time(PT)],blood routine indicators[platelet(PLT),red blood cell(RBC),hemoglobin(Hb)],inflammatory factor indicators[high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)],and occurrence of adverse events and recurrence were compared between the two groups.Result The overall effective rate of the children in the observation group was 93.88%,and the difference was not statistically significant compared with 89.80% of the control group(P>0.05).After the treatment,APTT and PT of the two groups were longer than those of the control group,the levels of FIB,hs-CRP,and IL-6 levels were lower than those before the treatment,and PLT,RBC,and Hb were higher than those before the treatment,the APTT and PT of the observation group were longer,the levels of FIB,hs-CRP,and IL-6 were lower,and the PLT,RBC,and Hb were higher than those of the control group,and the differences were statistically significant(P<0.05).The incidence of peripheral neuritis and allergic reactions in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The 6-month recurrence rate of children in the observation group was 2.04%,which was lower than 20.41% of the control group,and the difference was statistically significant(P<0.05).Conclusion Both the VDPAP program and the ADLP program c

关 键 词：急性淋巴细胞白血病 培门冬酶 VDPAP方案 ADLP方案 凝血功能 

分 类 号：R733.7[医药卫生—肿瘤]