| 王岳李学荣△ 仲任杨静孙立荣.培门冬酶治疗儿童急性淋巴细胞性白血病的不良反应观察[J].,2011,11(14):2691-2695 |
| 培门冬酶治疗儿童急性淋巴细胞性白血病的不良反应观察 |
| Adverse Reactions of Pegaspargase for Acute Lymphocytic Leukemia |
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| DOI： |
| 中文关键词: 培门冬酶 急性淋巴细胞白血病 大肠杆菌型 左旋门冬酰胺酶 不良反应 |
| 英文关键词: Pegaspargase Aute lymphocytic leukemia E-coli form L- asparaginase Adverse reactions |
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| 摘要点击次数: 835 |
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| 中文摘要: |
| 目的：观察左旋门冬酰胺酶两种常用剂型在急性淋巴细胞性白血病患儿联合化疗中的治疗反应。方法：本院2010.3-2010.12
行长春新碱+ 吡柔比星+ 门冬酰胺酶+ 强的松方案化疗的急性淋巴细胞白血病患儿，使用含有聚乙二醇化的左旋门冬酰胺酶剂
型培门冬酶即VDPAP 者作为A 组（40 例）与既往使用含大肠杆菌剂型即VDLP 者B 组（60 例）对比，观察不良反应。化疗前后检
测血象，肝功能，凝血功能，观察过敏情况等，记录化疗后第28 天的各项指标。结果：A 组过敏发生2 例（5%）而B 组过敏发生13
例（21.67%），P 值0.045，有统计学意义。既往对大肠杆菌剂型发生过敏的13 例患儿首剂使用PEG-Asp 均无过敏，2 例于第二剂时
出现皮试阳性。A 组（>2 级）白细胞减少16 例，中性粒细胞减少26 例，血红蛋白降低0 例，血小板减少5 例，纤维蛋白原降低1
例，部分凝血活酶时间延长0 例;B 组（>2 级）白细胞减少28 例，中性粒细胞减少46 例，血红蛋白降低2 例，血小板减少16 例，纤
维蛋白原降低2 例，部分凝血活酶时间延长0 例。A 组（未分级）抗凝血酶Ⅲ降低23 例，D 二聚体升高4 例，谷丙转氨酶升高5 例；
B 组（未分级）抗凝血酶Ⅲ降低33 例，D 二聚体升高8 例，谷丙转氨酶升高5 例。.血液学不良反应差异无统计学意义。A 组平均住
院日11.14 天。B 组平均住院日18.47 天。结论：左旋门冬酰胺酶两种剂型不良反应相当，但培门冬酶具有使用次数少，使用方便，
过敏率低，缩短住院日的优点。 |
| 英文摘要: |
| Objective: To investigate the adverse reactions of the two common dosage forms of L-asparagine enzyme in the combination
chemotherapy of acute lymphocytic leukemia. Methods: During January 2009 to December 2010, the children with acute lymphocytic
leukemia received the chemotherapy concluding Vincristine, Pirarubicin, Asparaginase and Prednisone. The patients using pegaspargase
which was the pegylation of L-asparaginase in VDPAP project were chosen as A group (40 cases), while the patients who using
L- asparaginase in the past were chosen as B group(60 cases) . The adverse reactions were detected. During the anterior-posterior combination
chemotheray, the hemogram, blood clotting function and the allergy were detected in the twenty-eighth day. Results: The allergy
occurred in 2 patients in group A (5%) and 13 cases of allergy in group B (21.67%), P=0.045,which was statistically significant. The rest
adverse reactions, including Leukopenia, neutropenia, thrombocytopenia, hypohemoglobinemia, hypoinosis, the extension of partial
thromboplastin time, the reduction of antithrombin Ⅲ, and the rise of alanine aminotransferase, hypoproteinemia, had no significant differences.
The average hospital stay of the patients in the Group A is 11.14 days while in the Group B is 18.47 days. Conclusion: There is
not much difference in adverse reactions of the two formulations of L-asparaginase ,but pegaspargase has the following advantages: less
frequency of use, easy to use, low allergy, reducing the hospital stay. |
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