左旋门冬酰胺酶治疗白血病患儿对凝血功能的影响

Effects of L-Asparaginase Administration on Coagulation Function in Children with Acute Lymphoblastic Leukemia

目的探讨左旋门冬酰胺酶(L-ASP)对凝血功能影响;比较国产与进口不同产品对凝血功能影响,静脉滴注与肌肉注射不同应用方式对凝血功能的影响。方法应用L-ASP化疗的急性淋巴细胞白血病(ALL)76例患儿,检测其治疗前后血纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)变化。结果47.4%出现APTT延长;其中国产44.4%,进口50.0%,无显著性差异(P>0.05);静脉滴注54.2%,肌肉注射35.7%,无统计学差异(P>0.1)。42.1%出现FIB降低;其中国产44.4%,进口40.0%,无显著性差异(P>0.5);静脉滴注47.9%,肌肉注射32.1%,无显著性差异(P>0.1)。颅内出血1例(1.3%)。结论1.L-ASP可影响凝血功能;2.国产和进口、静脉滴注和肌肉注射L-ASP对凝血功能的影响均无显著性差异。

Objective To investigate the side effects on coagulation function of L-asparaginase（L- ASP） used to treat acute lymphoblastic leukemia（ALL） patients; to compare the side effects caused by domestic L- ASP and foreign L- ASP, intravenous dosing and intramuscular dosihg. Methods The levels of fibrinogen（FIB） ,activated partial thromboplastin time（APTT） and prothrombin time（PT） of the 76 ALL patiens who were treated with L-ASP were tested after treatment with differem products and routes of adminislration. Results There were 47.4 % of patients whose APTT were prolonged, and there was no statistical difference in use of domestic L - ASP and foreign L ASP （44.4 % vs 50.0 %, P 〉 0.5 ） ; and so was between intravenous dosing and intramuscular dosing （ 54.2 % vs 35.7%, P〉0. 1）. Forty two point one percent of the patients had hypofibrinogenemia,which no statistical difference was shown between the use of domestic L - ASP and foreign L - ASP（44.4 % vs 40.0 %, Y 〉 0.5） ;and so was between administrations of intravenation and intramusculation （47.9 % vs 32.1%, P 〉0.1 ）. One（ 1.3% ） of them suffered from intraeranial hemorrhage. Conclusions 1. L ASP may affect the function of coagulation system, such as prolonged APTT and hypofibrinogenemia. 2. There was no statistical difference in side effects of coagulation, in use of domestic L-ASP and foreign L-ASP, intravenous dosing and intramuscular dosing.