摘要
目的观察大剂量氨甲喋呤对急性淋巴细胞性白血病（ＡＬＬ）患儿各脏器功能的影响和毒副作用。方法采用自身对照法对１７例处于完全缓解期的ＡＬＬ患儿，应用大剂量氨甲喋呤前后对各脏器功能进行对比。结果胃肠道、皮肤粘膜、肝、肾、肺存在损害。对内分泌、免疫功能等有一定影响。药物热及心脏、神经损害少见，均为一过性发生。Ｘ线胸片为非特异性改变。嗜酸性粒细胞显著增高（Ｐ＜０．０５）。肺功能检查中肺活量、用力肺活量、１秒量、峰流速、５０％肺活量最大呼气流量／２５％肺活量最大呼气流量均显著降低；４例为限制性通气障碍。血清补体Ｃ３，ＣＨ５０显著下降。结论大剂量氨甲喋呤对ＡＬＬ患儿呼吸等部分脏器和组织有损害，但不严重，均能坚持进行治疗。
Objective To observe the impact of high dose methotrexate (HDMTX) on respiratory function and other organs functions as well as its adverse effects. Methods Seventeen children with acute lymphoblastic leukemia in complete remission were studied in a self control trial. Results Gastrointestinal reaction and mucocutaneous, hepatic, renal and pulmonary damage were noticed. To some extent, transient impairment of endocrine and immune functions was observed. Cardiac and neurologic damage and drug fever were rare. Chest roentgenologic findings were non specific. Peripheral eosinophilic granulocyte was increased significantly ( P <0.05) and serum complement C 3, CH 50 decreased after HDMTX administration. The significant decreases in the vital capacity, the forced expiratory volume in the first second of expiration, the forced vital capacity (FVC), the peak expiratory flow and the maximum expiratory flow at 50% FVC/at 25% FVC were observed after HDMTX. Four cases showed restrictive ventilation dysfunction. Conclusion The results of this study demonstrated that pulmonary damage potentiated by HDMTX might be an immune mediated process with a favorable outcome.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
1998年第1期8-11,共4页
Chinese Journal of Pediatrics
