摘要
目的探讨双歧杆菌制剂对大剂量甲氨蝶呤(HD-MTX)治疗ALL患儿所致胃肠道不良反应的影响。方法参照儿童ALL诊疗建议,将152例ALL患儿随机分为2组。治疗组76例。男46例,女30例;年龄2～13岁(中位年龄8岁)。对照组76例。男41例,女35例;年龄2～15岁(中位年龄8.2岁)。2组均为HD-MTX强化及预防性治疗中枢神经系统白血病。治疗组在入院时即予双歧杆菌制剂常规口服(金双歧片:2～6岁,每次1片,每日3次;7～15岁,每次2片,每日3次),3d后开始化疗,双歧杆菌制剂与化疗药物间隔2～3h服用,若WBC<2.0×109L-1即停用。对照组口服复合维生素B片(2～6岁,每次1片,每日3次;7～15岁,每次2片,每日3次)。治疗期间2组均予相应的对症支持治疗(即水化、碱化及四氢叶酸钙解救)。结果双歧杆菌制剂对HD-MTX化疗引起的消化道不良反应有显著改善作用,治疗组恶心、腹痛、腹泻等消化道症状均较对照组显著减轻,肝功能损害亦较对照组减轻。但对于ALL患儿化疗过程中合并的发热和口腔黏膜损害等症状无明显减轻作用。结论双歧杆菌制剂可显著改善白血病患儿HD-MTX化疗引起的胃肠道不良反应。
Objective To observe the effect of bacillus bifidus preparation on the prevention of gastrointestinal side effects in children with acute lymphocyte leukemia （ALL） during high-dose methotrexate （HD-MTX） chemotherapy.Methods One hundred and fifty-two ALL children were randomly assigned into 2 groups according to the suggestion of diagnosis and treatment of ALL in childhood.There were 76 patients in each group.In the treatment group,there were 46 male and 30 female,aged 2 to 13 years old （the median age was 8 years）.While in the control group,there were 41 male and 35 female （the median age was 8.2 years）.They were treated with the same chemotherapy schedule （HD-MTX）,supportive therapies and infection preventive measures.ALL children in the treatment group were additionally given the bacillus bifidus preparation （one tablet for 2 to 6 years old,and two tablets for 7 to 15 years old,3 times daily）,if their WBC was more than 2.0×10^9 L^-1.Those in the control group were given vitamin B complex tablets （one tablet for 2 to 6 years old and two tablets for 7 to 15 years old,3 times daily）.Results ALL children in treatment group had less diarrhea,abdominal pain,nausea and vomiting,or liver function impairment induced by chemotherapy than those in control group.However,the bacillus bifidus preparation had no significant effects on the symptoms of fever and oral mucosal erosions in the period of chemotherapy.Conclusion The bacillus bifidus preparation is clinically useful for the prevention of gastrointestinal side effects associated with HD-MTX chemotherapy.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2010年第15期1185-1186,共2页
Journal of Applied Clinical Pediatrics
关键词
双歧杆菌
微生态制剂
白血病
儿童
bacillus bifidus
probiotics preparation
leukemia
child
