不同剂量氨甲蝶呤治疗急性淋巴细胞白血病患儿的临床疗效  

Clinical efficacy of different doses of methotrexate in children with acute lymphocytic leukemia

作　　者：薛营 尼晓丽 赵金环 朱慧芳 刘青颖 XUE Ying;NI Xiaoli;ZHAO Jinhuan;ZHU Huifang;LIU Qingying(Department of Pediatric Internal Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,He’nan,China)

机构地区：[1]郑州大学第一附属医院小儿内科,郑州4500000

出　　处：《癌症进展》2023年第24期2694-2697,共4页Oncology Progress

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20190214)。

摘　　要：目的探讨不同剂量氨甲蝶呤治疗急性淋巴细胞白血病(ALL)患儿的临床疗效。方法依据氨甲蝶呤剂量的不同将99例ALL患儿分为对照组(n=49)和观察组(n=50),对照组患儿给予常规剂量(3 g/m^(2))氨甲喋呤治疗,观察组患儿给予高剂量(5 g/m^(2))氨甲蝶呤治疗。比较两组患儿的临床疗效、血清肿瘤标志物[肝细胞生长因子(HGF)、β_(2)-微球蛋白(β_(2)-MG)]水平、心理状态[抑郁自评量表(SDS)、焦虑自评量表(SAS)]、生活质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]及不良反应发生情况。结果治疗后,观察组患儿的总有效率为94.00%,高于对照组患儿的79.59%(P<0.05)。治疗后,两组患儿血清HGF、β_(2)-MG水平均低于本组治疗前,观察组患儿血清HGF、β_(2)-MG水平均低于对照组(P<0.05)。治疗后,两组患儿SDS、SAS评分均低于本组治疗前,EORTC QLQ-C30量表各维度评分均高于本组治疗前,观察组患儿SDS、SAS评分均低于对照组,EORTC QLQ-C30量表各维度评分均高于对照组,差异均有统计学意义(P<0.05)。两组患儿口腔黏膜损伤、骨髓抑制、胃肠道反应、肝功能减退发生率比较,差异均无统计学意义(P>0.05)。结论高剂量氨甲蝶呤治疗ALL患儿的疗效显著,可改善患儿焦虑、抑郁等不良情绪,改善生活质量,且安全性较高。Objective To explore the clinical efficacy of different doses of methotrexate in children with acute lymphoblastic leukemia(ALL).Method A total of 99 ALL children were divided into control group(n=49)and observation group(n=50)according to different methotrexate dose.The children in control group were administrated conventional dose(3 g/m^(2))of methotrexate,and the children in observation group were administrated high dose(5 g/m^(2))of methotrexate.The clinical efficacy,tumor markers[hepatocyte growth factor(HGF),β_(2)-microglobulin(β_(2)-MG)],psychological state[self-rating depression scale(SDS),self-rating anxiety scale(SAS)],quality of life[European Organization for Research and Treatment of Cancer quality of life questionnaire core 30(EORTC QLQ-C30)]and adverse reactions were compared between two groups.Result After treatment,the total effective rate of the observation group was 94.00%,which was higher than 79.59%of the control group(P<0.05).After treatment,the serum levels of HGF andβ_(2)-MG in the two groups were lower than those before the treatment,and the serum levels of HGF andβ_(2)-MG in the observation group were lower than those in the control group(P<0.05).After treatment,the scores of SDS and SAS in both groups were lower than those before the treatment,scores of all dimensional EORTC QLQ-C30 were higher than those before the treatment,the SDS and SAS scores of the observation group were lower than those of the control group,and the scores of all dimensions of the EORTC QLQ-C30 scale were higher than those of the control group,the differences were statistically significant(P<0.05).There were no significant differences in the incidence of oral mucosal injury,bone marrow suppression,gastrointestinal reactions,and liver dysfunction between the two groups(P>0.05).Conclusion High-dose methotrexate can improve the clinical efficacy of ALL children,improve anxiety,depression and other adverse emotions,and improve the quality of life with higher safety.

关 键 词：急性淋巴细胞白血病 氨甲蝶呤 综合干预 临床疗效 

分 类 号：R733.7[医药卫生—肿瘤]