• 溫州醫(yī)學(xué)院育英兒童醫(yī)院血液科,浙江溫州 325027;

目的:了解左旋門冬酰胺酶(L-ASP)對兒童急性淋巴細(xì)胞白血病凝血功能變化的影響。方法:觀察86例患兒在誘導(dǎo)緩解后治療期間,L-ASP使用前后活化部分凝血活酶時(shí)間(APTT)、凝血酶原時(shí)間(PT)、凝血酶時(shí)間(TT)、纖維蛋白原(FIB)、抗凝血酶Ⅲ(AT-Ⅲ)、D-二聚體變化情況。結(jié)果:與用藥前比,用藥結(jié)束后一天的PT、APTT、TT均顯著延長(P<0.01);FIB、AT-Ⅲ顯著降低(P<0.01),D-二聚體顯著升高(P<0.01);用藥結(jié)束后1周時(shí)PT、APTT、TT、D-二聚體較用藥前差異無顯著性,FIB、AT-Ⅲ雖有回升,但仍低于正常(P<0.01)。結(jié)論:L-ASP可引起ALL患兒凝血功能異常,尤其對FIB、AT-Ⅲ影響明顯,應(yīng)引起臨床高度重視。L-Asp主要影響蛋白質(zhì)的合成而引起蛋白質(zhì)成份的凝血因子減少,從而引起凝血功能障礙,且對纖維蛋白原的合成影響更為顯著。

引用本文: 李原,王菊香,周海霞,錢江潮,方希敏,曾煒煒,徐霞. 兒童急性淋巴細(xì)胞白血病凝血功能變化與左旋門冬酰胺酶的關(guān)系. 華西醫(yī)學(xué), 2008, 23(1): 119-120. doi: 復(fù)制

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  1. 1. [1]顧龍君,孫桂香,盧新天,等.小兒急性淋巴細(xì)胞白血病診療建議(第二次修訂草案)[J].中華兒科雜志,1999,37(5):305-307..
  2. 2. 張永紅,趙新民,耿蘭增.與左旋門冬酰胺酶治療相關(guān)的低蛋白血癥3例[J].白血病,1997,7(4):242..
  3. 3. 唐迪生,毛娟紅.臨床實(shí)用藥物及其藥理基礎(chǔ)[M].上海:復(fù)旦大學(xué)出版社,1996:322.
  4. 4. Murakawa M,Okamura T,Shibuya T,et al.Use of a synthetic protease inhibitor for the treatment of L-asparaginase-induced acute pancreatitis complicated by disseminatedintravascular coagulation[J].Ann Hematol,1992,64(5):249..
  5. 5. Halton JM,Mitchell LG,Vegh P,et al. Fresh frozen plasma has no beneficial effect on the homeostatic system in children receiving L-asparaginase[J].Am J Hematol,1994,47(3):157-161..
  6. 6. Shapiro AD,Clarke SL,Christian JM,et al.Thrombosis in children receiving L-asparaginase[J].Am J Pediatr Oncol,1993,15(4):400.