门冬酰胺酶治疗儿童淋巴系统恶性肿瘤的严重并发症  

Serious complications of L-asparaginase in children with lymphatic system maliganancy

作　　者：杨双[1] 石慧文[1] 吴敏媛[1] 段渊[1] 张永红[1] 耿兰增[1] 赵新民[1] 胡亚美[1] 

机构地区：[1]首都医科大学附属北京儿童医院血液病中心,北京100045

出　　处：《实用儿科临床杂志》2003年第6期430-432,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的　观察门冬酰胺酶 (L ASP)在儿童急性淋巴细胞白血病 (ALL)及Ⅲ、Ⅳ期非霍奇金淋巴瘤(NHL)应用中严重并发症 ,探讨L ASP化疗顺利完成的有效对策。方法　针对L ASP的各种主要并发症制定相应的检测手段及监测指标 ,在应用L ASP期间对患儿进行监测 ,对出现并发症采取相应的检测。统计各并发症的发生率、发生时间。结果　用L ASP化疗的ALL和NHL患儿总计 30 1例次 ,其中L ASP相关严重并发症2 0例次 ( 6 .6 % ) ,高血糖 7例次 ( 2 .32 % ) ;低血糖 1例次 ( 0 .33% ) ;胰腺炎 6例次 ( 1.99% ) ;脑栓塞 2例次( 0 .6 6 % ) ;弥散性血管内凝血 (DIC) 6例次 ( 1.99% ) ;脏器出血 4例次 ( 1.32 % ) ;休克 7例次 ( 2 .3% ) ;死亡 10例 ( 3.3% )。结论　L ASP的细胞毒作用可造成人体各系统的损害 ,严重者甚至危及生命。严密、合理的监测手段及早期干预可明显降低L ASP并发症。Objective In order to insure the successful use of L asparaginase(L ASP) in childhood lymphoblastic leukemia and non Hodgkin's lymphoma ,we observed the serious complications of L ASP. Methods We designed measurements and items to detect and monitor the complications of L ASP. The incidence and onset time of each complication were summarized. Results Twenty of 301 patients(6.6 %) developed serious complications which were most probably due to L ASP therapy . We observed 6 children (1.99 %) had pancreatitis. Hyperglycemia were observed in 7 patients (2.32 %). One patient developed hypoglycemia (0.33 %). Centralnevous system thrombosis were observed in 2 patients(0.66 %). Haemorrhagic and shock were observed in 4 and 15 patients separately. Six patients(1.99 %) developed DIC. Seven patients(2.3 %)developed shock .Ten patients(3.3 %) died of various complications. Conclusions The cytotoxic effect of L ASP may cause systemic damage to patients,even lethiferous.Close and reasonable monitoring and early interventions may decrease the incidence and hazard of the L ASP complications obviously.

关 键 词：门冬酰胺酶 儿童 肿瘤 并发症 

分 类 号：R733[医药卫生—肿瘤]