左旋门冬酰胺酶治疗儿童恶性肿瘤的毒副作用及其防治研究

Preventing the adverse effect of L-asparaginase during the chemotherapy in children with malignant tumors

目的 探讨左旋门冬酰胺酶 (L ASP)化疗的毒副作用及可行的防治方法。方法 回顾分析 139个疗程L ASP的使用 ,比较曾使用预防某种毒副作用措施的疗程及未使用预防该毒副作用措施的疗程的毒副作用发生率 ,分析防治措施的有效性。结果 139个疗程中 4 4个疗程产生如下毒副作用 :凝血障碍、过敏、急性胰腺炎、消化道反应、糖尿病、低蛋白血症、高脂血症。 5例患儿因L ASP毒副作用死亡。给予预防措施疗程和无预防措施疗程毒副作用发生率的差异有显著性意义。结论 积极预防可减少L ASP毒副作用 ,保证化疗顺利进行 ;及时诊断和处理L ASP毒副作用可减少严重合并症的发生 。

Objective To investigate the effective way in preventing and treating the adverse effect of L asparagine (L Asp).Methods 139 courses of chemotherapy were retrospectively analyzed in this study. The adverse effect rate was compared between the patients under prevention (P group) and patients without prevention (N P group).Results 44 out of 139 courses of chemotherapy presented several degree of the side effects, like coagulopathy, allergy, acue pancreatitis, gastrointestinal reaction, diabetes, hypoproteinemia and hyperlipidemia. 5 patients died of these side effects. The adverse effect rate was significantly different between the P and N P group. Conclusion The side effects of L Asp could be decreased by careful prevention. Reduced occurence of complication and improved living quality of the patients might be achieved by early recognizing these effects.