儿童急性淋巴细胞白血病化疗前后骨代谢研究

目的 　研究急性淋巴细胞白血病 (ALL)患儿化疗前后骨代谢状况。方法 　对 32例ALL患儿化疗前及化疗缓解后 3个月、1 2个月分别测定血清Ⅰ型胶原羧基端前肽 (PICP)、尿脱氧吡啶啉 (deoxypyridinoline ,DPD)排泄率并行骨骼X线检查 ,同期健康体检儿童 30例设为对照组。结果 　治疗前PICP及尿DPD排泄率较对照组增高 ,治疗后 3个月、1 2个月PICP较治疗前及对照组降低 ,尿DPD排泄率较治疗前下降 ,但仍高于对照组 ,经t检验 ,差异具有显著性 (P <0 0 1 )。结论 　ALL患儿治疗前存在骨质溶解 ,骨质吸收 ;化疗缓解后出现骨形成障碍 ,仍存在骨质吸收 ,可能与化疗药物应用有关。

Study on bone metabolism in children with acute lymphocytic leukemia before and after chemotherapy

Objective To study the status of bone metaboli sm in children with acute lymphocytic leukemia (ALL) before and after administrate d by chemotherapy. Methods Serum carboxyl terminal propeptide of procollagen type Ⅰ(PICP) and excretory rate of deoxypyridinoline (DPD),and X -ray photography to femur and pelvis were studied in 32 cases with ALL and 30 no rmal children (control group) at 3m and 12m before chemotherapy and after complete re mission, respectively .Results The results showed PICP and DP D/Cr of children with ALL significantly increased compared to that in control gr oup (P<0.01). However, PICP at 3m and 12m followed by treatment decreased c ompared to that before chemotherapy,and in control group. DPD/Cr decreased compa red to that before chemotherapy, but increased compared to that in control group (P<0.01) .Conclusions These results suggest that osteo ly sis and bone absorption exist in children with ALL before chemotherapy. But oste ogenesis disorder and bone absorption after remission may be related to drugs du ring administrated by chemotherapy. <