摘要
目的探讨急性淋巴细胞性白血病(ALL)患儿应用左旋门冬酰胺酶(L-ASP)联合化疗期间药物性高血糖发生的概率及高危因素,以及药物性高血糖与药物性胰腺炎的相关性。方法 2002年5月1日至2008年4月30日共收治594例ALL患儿,以2005年5月1日为分界线,之前的197例ALL初治患儿和43例复发再治患儿应用XH-99方案;之后的354例患儿按儿童ALL-05方案进行化疗。在应用L-ASP联合化疗期间检测空腹血糖,对发生药物性高血糖的患儿采取暂缓L-ASP化疗,减少激素剂量,以及糖尿病饮食控制和注射胰岛素的治疗措施。结果共12例患儿发生药物相关性高血糖,发生率为2.02%;发生高血糖患儿与未发生高血糖患儿比较,中位年龄差异有统计学意义(11.5岁对5.0岁,P<0.01)。两种治疗方案患儿药物性高血糖发生率差异无统计学意义(P=0.26)。12例药物性高血糖患儿经治疗后,均得到控制。未发生药物性高血糖的患儿中发生药物相关性胰腺炎2例。结论 ALL患儿采用L-ASP联合化疗期间,药物性高血糖发生率约2%,年龄是发生药物性高血糖的重要因素,药物性高血糖可控制。[临床儿科杂志,2012,30(5):415-417]
Objective To explore the incidence,risk factors and correlation between hyperglycemia and druginduced acute pancreatitis in children with acute lymphoblastic leukemia（ALL） under chemotherapy combined with L-asparaginase（L-ASP）.Methods A total of 594 ALL patients were collected from May 1st 2002 to April 30th 2008.One hundred and ninety-seven initial treated patients and 43 relapsed patients collected before May 1st 2005 were applied with XH-99 protocol,while the other 354 patients collected after were treated with ALL-05 protocol.The fasting blood glucose was tested for all patients during the period of combinational chemotherapy including L-ASP.The chemotherapy was reprieved and the dose of steroids was reduced when drug-induced hyperglycemia occurred.Meanwhile,the diabetic diet and insulin treatment were also provided.Results A total of 12 children developed drug-induced hyperglycemia with a rate of 2.02%.There was a significant age difference between hyperglycemia children and non-hyperglycemia ones（P 0.01）.Difference between two protocols was not observed in incidence of hyperglycemia（P = 0.26）.All the 12 children with drug-induced hyperglycemia were within control after proper treatment.Conclusions The incidence of hyperglycemia associated with combination chemotherapy including L-asparaginase is about 2%.The key risk factor is the age when diagnosis is made initially.The drug-induced hyperglycemia can be controlled.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2012年第5期415-417,共3页
Journal of Clinical Pediatrics
