蚌埠医学院学报
蚌埠醫學院學報
방부의학원학보
ACTA ACADEMIAE MEDICINAE BENGBU
2015年
5期
616-618
,共3页
白血病,淋巴细胞性,急性%甲氨蝶呤%不良反应
白血病,淋巴細胞性,急性%甲氨蝶呤%不良反應
백혈병,림파세포성,급성%갑안접령%불량반응
leukemia,lymphoblastic,acute%methotrexate%adverse reactions
目的：：探讨大剂量甲氨蝶呤( HD-MTX)治疗儿童急性淋巴细胞白血病( ALL)的不良反应。方法：对40例ALL患儿采用HD-MTX 2.0~5.0 g/m2治疗，观察治疗后患儿的临床症状和体征，并统计不良反应发生率。结果：经过3个疗程的临床治疗后，患儿出现了骨髓抑制、胃肠道反应、感染、肝损害、黏膜损害、心脏损害、神经系统症状、皮疹及脱发等不良反应。其中，骨髓抑制发生率为61.3%，胃肠道反应发生率为51.9%，感染发生率为38.1%，肝损害发生率为41.3%，黏膜损害发生率为15.6%，心脏损害发生率为10.0%，神经系统症状发生率为15.0%，皮疹发生率为6.9%，脱发发生率为5.0%；未见明显的肾功能损害。结论：HD-MTX治疗ALL患儿的不良反应较多，要积极对症治疗，加强对MTX血药浓度的监测以及个体化治疗，以提高患儿的长期无病生存率。
目的：：探討大劑量甲氨蝶呤( HD-MTX)治療兒童急性淋巴細胞白血病( ALL)的不良反應。方法：對40例ALL患兒採用HD-MTX 2.0~5.0 g/m2治療，觀察治療後患兒的臨床癥狀和體徵，併統計不良反應髮生率。結果：經過3箇療程的臨床治療後，患兒齣現瞭骨髓抑製、胃腸道反應、感染、肝損害、黏膜損害、心髒損害、神經繫統癥狀、皮疹及脫髮等不良反應。其中，骨髓抑製髮生率為61.3%，胃腸道反應髮生率為51.9%，感染髮生率為38.1%，肝損害髮生率為41.3%，黏膜損害髮生率為15.6%，心髒損害髮生率為10.0%，神經繫統癥狀髮生率為15.0%，皮疹髮生率為6.9%，脫髮髮生率為5.0%；未見明顯的腎功能損害。結論：HD-MTX治療ALL患兒的不良反應較多，要積極對癥治療，加彊對MTX血藥濃度的鑑測以及箇體化治療，以提高患兒的長期無病生存率。
목적：：탐토대제량갑안접령( HD-MTX)치료인동급성림파세포백혈병( ALL)적불량반응。방법：대40례ALL환인채용HD-MTX 2.0~5.0 g/m2치료，관찰치료후환인적림상증상화체정，병통계불량반응발생솔。결과：경과3개료정적림상치료후，환인출현료골수억제、위장도반응、감염、간손해、점막손해、심장손해、신경계통증상、피진급탈발등불량반응。기중，골수억제발생솔위61.3%，위장도반응발생솔위51.9%，감염발생솔위38.1%，간손해발생솔위41.3%，점막손해발생솔위15.6%，심장손해발생솔위10.0%，신경계통증상발생솔위15.0%，피진발생솔위6.9%，탈발발생솔위5.0%；미견명현적신공능손해。결론：HD-MTX치료ALL환인적불량반응교다，요적겁대증치료，가강대MTX혈약농도적감측이급개체화치료，이제고환인적장기무병생존솔。
Objective:To investigate the clinical adverse reactions of high-dose methotrexate(HD-MTX) in the treatment of children with acute lymphoblastic leukemia(ALL). Methods:Forty cases of children with ALL were treated with HD-MTX(2. 0-5. 0 g/m2). The clinical signs and symptoms were observed and the incidence rates of adverse reactions were counted. Results:After three courses of treatment,some adverse reactions,such as,bone marrow suppression,gastrointestinal reactions,infection,liver injury,mucosal damage, heart damage, neurological symptoms, rash and alopecia appeared. The incidence rate of bone marrow suppression, gastrointestinal reactions,infection, liver injury, mucosal damage, heart damage, neurological symptoms, rash and alopecia was 61. 3%, 51. 9%, 38. 1%,41. 3%,15. 6%,10. 0%,15. 0%,6. 9% and 5. 0%,respectively,but obvious renal injury did not appear. Conclusions:There were many adverse reactions of HD-MTX in the treatment of children with ALL, and it is important to carry out active symptomatic treatment,strengthen the monitoring of plasma concentrations of MTX and individualize treatment protocols,in order to increase the rate of long-term disease free survival.
