259例急性淋巴细胞白血病患儿化疗致肝损伤相关因素分析  

Risk factors of liver injury in 259 children with acute lymphoblastic leukemia after chemotherapy

作　　者：耿伟[1] 杨东亮[1] 别克杜曼·巴哈提 朱青梅[1] GENG Wei;YANG Dongliang;Biekeduman Bahati;ZHU Qingmei(Department of Pharmacy,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,830054,China;College of Pharmacy,Xinjiang Medical University,Urumqi,830011,China)

机构地区：[1]新疆医科大学第一附属医院,乌鲁木齐830054 [2]新疆医科大学药学院,乌鲁木齐830011

出　　处：《新疆医学》2024年第1期38-40,49,共4页Xinjiang Medical Journal

基　　金：新疆维吾尔自治区药学会科研基金(项目编号:YXH202115)。

摘　　要：目的总结儿童急性淋巴细胞白血病(Acute lymphoblastic leukemia,ALL)患者化疗后发生肝损伤的情况,研究性分析ALL患儿发生肝损伤的危险因素。方法回顾性分析2019年1月-2022年4月新疆医科大学第一附属医院儿科259例ALL患儿化疗的临床资料,对年龄、体重指数(BMI)、性别、化疗阶段、白蛋白水平、血红蛋白水平、否使用大剂量甲氨蝶呤、感染、髓外预防相关因素进行数据搜集,先单因素分析,对显著性影响的因素再采用logistic回归进行多因素分析。结果单因素分析结果表明性别、各年龄段、不同BMI、各化疗阶段及是否使用大剂量甲氨蝶呤对化疗后肝损伤的发生均不具有统计学意义(P>0.05)。鞘内注射、贫血、低蛋白血症、感染更容易发生化疗后肝损伤,差异均具有统计学意义。Logistic回归结果表明低蛋白血症是化疗后肝损伤发生的独立危险因素。结论儿童ALL化疗肝损伤的发生率与贫血、低蛋白血症、感染、髓外预防有关。低蛋白血症是化疗后肝损伤的独立影响因素,化疗前需给予适当治疗,从而降低化疗后肝损伤的发生率。Objective To summarize the occurrence of liver injury in the course of chemotherapy in children with acute lymphoblastic leukemia(ALL)and to investigate the risk factors for liver function injury resulting from chemotherapy.Methods A retrospective analysis was performed on the clinical data of 259 ALL patients who were treated with chemotherapy in the Department of Pediatrics of the Affiliated Hospital of Xinjiang Medical University from January 2019 to April 2022.The data of age,gender,body mass index(BMI),chemotherapy stage,hemoglobin level,albumin level,infection and extramedullary prophylaxis were collected.Univariate analysis was performed first to screen out the factors with significant influence,and then logistic regression was used for multivariate analysis.Results Univariate analysis showed that gender,age,BMI,chemotherapy stage and whether to use high-dose methotrexate had no statistical significance on the occurrence of liver injury after chemotherapy(P>0.05).Intrathecal injection,anemia,hypoproteinemia and infection were more likely to cause liver injury after chemotherapy,and the differences were statistically significant(P<0.05).Logistic regression showed that hypoproteinemia was an independent risk factor for liver injury after chemotherapy.Conclusion The incidence of liver injury in children with ALL is associated with anemia,hypoproteinemia,infection and extramedullary prophylaxis.Hypoproteinemia is an independent influencing factors of liver injury after chemotherapy.Proper treatment is required to reduce the incidence of liver injury after chemotherapy.

关 键 词：急性淋巴细胞白血病 儿童 化疗 肝损伤 危险因素 

分 类 号：R575[医药卫生—消化系统]