中国医学前沿杂志（电子版）
中國醫學前沿雜誌（電子版）
중국의학전연잡지（전자판）
CHINESE JOURNAL OF THE FRONTIERS OF MEDICAL SCIENCE(ELECTRONIC VERSION)
2015年
7期
126-129
,共4页
肝脏毒性%急性淋巴细胞白血病%培门冬酶
肝髒毒性%急性淋巴細胞白血病%培門鼕酶
간장독성%급성림파세포백혈병%배문동매
Hepatotoxicity%Acute lymphoblastic leukemia%Polyethylene glycol conjugated L-asparaginase
目的：观察治疗剂量的培门冬酶对急性淋巴细胞白血病（acute lymphoblastic leukemia，ALL）患儿的肝脏毒性。方法观察本院儿科2012年10月至2014年7月使用培门冬酶化疗的48例ALL患儿肝损伤的临床表现，并动态监测患儿肝功能指标变化。结果48例患儿中28例出现肝损伤，其中22例有临床表现，以消化道症状、肝肿大及黄疸为主；应用培门冬酶治疗前后，患儿肝功能指标γ-谷氨酰转肽酶（γ-GT）、总蛋白等无明显变化；谷丙转氨酶（ALT）水平第1周升高，第2周明显升高，第3周恢复正常；谷草转氨酶（AST）和总胆红素水平第2周轻度升高，清蛋白水平第2周轻中度下降，且均能于3周内恢复正常。结论培门冬酶治疗儿童ALL引起的肝损伤以消化道症状及肝脏肿大为主要临床表现，肝损伤程度较轻，经治疗一般均能恢复正常，但应动态监测肝功能指标变化。
目的：觀察治療劑量的培門鼕酶對急性淋巴細胞白血病（acute lymphoblastic leukemia，ALL）患兒的肝髒毒性。方法觀察本院兒科2012年10月至2014年7月使用培門鼕酶化療的48例ALL患兒肝損傷的臨床錶現，併動態鑑測患兒肝功能指標變化。結果48例患兒中28例齣現肝損傷，其中22例有臨床錶現，以消化道癥狀、肝腫大及黃疸為主；應用培門鼕酶治療前後，患兒肝功能指標γ-穀氨酰轉肽酶（γ-GT）、總蛋白等無明顯變化；穀丙轉氨酶（ALT）水平第1週升高，第2週明顯升高，第3週恢複正常；穀草轉氨酶（AST）和總膽紅素水平第2週輕度升高，清蛋白水平第2週輕中度下降，且均能于3週內恢複正常。結論培門鼕酶治療兒童ALL引起的肝損傷以消化道癥狀及肝髒腫大為主要臨床錶現，肝損傷程度較輕，經治療一般均能恢複正常，但應動態鑑測肝功能指標變化。
목적：관찰치료제량적배문동매대급성림파세포백혈병（acute lymphoblastic leukemia，ALL）환인적간장독성。방법관찰본원인과2012년10월지2014년7월사용배문동매화료적48례ALL환인간손상적림상표현，병동태감측환인간공능지표변화。결과48례환인중28례출현간손상，기중22례유림상표현，이소화도증상、간종대급황달위주；응용배문동매치료전후，환인간공능지표γ-곡안선전태매（γ-GT）、총단백등무명현변화；곡병전안매（ALT）수평제1주승고，제2주명현승고，제3주회복정상；곡초전안매（AST）화총담홍소수평제2주경도승고，청단백수평제2주경중도하강，차균능우3주내회복정상。결론배문동매치료인동ALL인기적간손상이소화도증상급간장종대위주요림상표현，간손상정도교경，경치료일반균능회복정상，단응동태감측간공능지표변화。
ObjectiveTo study the hepatotoxicity of polyethylene glycol conjugated L-asparaginase (PEG-Asp) with therapeutic dose in children with acute lymphoblastic leukemia (ALL).MethodA study of 48 ALL children in department of pediatrics of our hospital from October 2012 to July 2014 was performed, and their hepatotoxicity were monitored, included the observation of treatment response and dynamic changes in hepatic function.Result28 cases of the 48 children had suffered liver function damage. Among them, 22 children with clinical manifestations, included digestive tract symptom, liver enlargement and jaundice. The liver function index serum γ-GT and total protein had no signiifcant changes before and after treatment with PEG-Asp; ALT had elevated in the ifrst week, and signiifcantly increased in the second week, and in the third week, it returned to normal level; AST and total bilirubin appeared slightly increased in the second week, and albumin at the second week showed mild to moderate decline, and all of the laboratory indexes can recover to normal level within three weeks.ConclusionDigestive tract symptom are the main performance in the ALL children which suffered hepatic toxicity by PEG-Asp the hepatic dysfunction is gently and transient and usually reversible. But the dynamic changes should be observed closely.
