急性淋巴细胞白血病大剂量甲氨蝶呤化疗中护肝药物应用的必要性研究.docVIP

急性淋巴细胞白血病大剂量甲氨蝶吟化疗中护肝药物应用的必要性研究 黄闪刘炜 (郑州市儿童医院血液肿瘤科 河南 郑州450000) 口的研究急性淋巴细胞口血病大剂量甲氨蝶吟化疗屮护肝药物 应用的必要性。方法收集本院2012年1月?2015年1月4年间156例在本院 给予大剂量甲氨蝶吟化疗患儿化疗期间ALT、AST、ALP、TBA、TBil等肝酶的变化， 按化疗初即给予护肝药物和不给予护肝药物分为两组，研究两组患儿化疗后转氨 酶的转归。结果两组患儿化疗后ALT、AST、ALP、TBA、TBil等肝酶的变化无明 显统计学差异(Pgt；0.05)o结论急性淋巴细胞白血病大剂量甲氨蝶吟化疗期 间给予护肝药物治疗不能明显降低化疗药物肝损害程度，因此大剂量甲氨蝶吟化 疗可不常规给予护肝药物治疗。 关键词 甲氨蝶吟；急性淋巴细胞白血病；儿童；肝功能 屮图分类号 R575 A 2095-1752 (2016) 21-0046-03 Clinical studies of the necessity of application of lump drugs of high-dose methotrexate on liver in childre n with acute lymphoblastic leukemia Hua ng sha n, Liu wei. Department of Hematology and Oncology, Childrenrsquo;s Hospital of Zhengzhou City, Hersquo;nan Provinee, Zhengzhou 450000, China [Abstract] Objective To study the necessity of application of lump drugs of high-dose methotrexate on liver in children with acute lymphoblastic leukemia.Methods From Jan 2012 to Jan 2015,156 hospitalized children with acute lymphoblastic leumia were enrolled in the study and divided into two groups: protect liver of the beginning of the chemotherapy(76 cases) and no protect liver of the beginning of the chemotherapy( 80 cases), tio study the viriation of the function of liver between the pre and post chemotherapy. Results There were no ststistical differences between the levels of ALT AST ALP gamma;-GT in both groups at post chemotherapy. Conclusion Acute lymphocytic leukemia during high-dose methotrexate chemothrexate chemotherapy to protect liver medicine not significantly reduce chemothereapy drugs liver damage degree, so the high-dose mrthotreate chemotherapy is not normal to protect liver medicine. Key words] Methotrexate ; Acute lymphoblastic leumia;Children;liver function 大剂量甲氨蝶吟是目前联合化疗治疗急性淋巴细胞白血病方案的主要组成 部分，主要用于预防中枢神经系统及睾丸白血病。个体间MTX存在较人的药物 动力学及血药浓度存在较大差异，已有多项研究表明，大剂量甲氨蝶吟化疗可产 生严重毒副作用，如肝、肾损害、皮肤黏膜损害、骨髓抑制、胃肠道反应以及与 此相关的继发感染及出血等，同时剂量越人，患儿岀现不良反应的几率就越人, 需加大预防性保护药物剂量，增加患儿经济及心理负担。本研究总结120例 ALL3-13岁患儿给予3g/m2大剂量MTX的血浓度及对患儿肝功能的影响，为临床 治疗提供参考。 1 ?研究对象及方法 1.1病历入选标准