左旋门冬酰胺酶治疗白血病患儿对凝血功能的影响

目的探讨左旋门冬酰胺酶(L-ASP)对凝血功能影响;比较国产与进口不同产品对凝血功能影响,静脉滴注与肌肉注射不同应用方式对凝血功能的影响。方法应用L-ASP化疗的急性淋巴细胞白血病(ALL)76例患儿,检测其治疗前后血纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)变化。结果47.4%出现APTT延长;其中国产44.4%,进口50.0%,无显著性差异(P>0.05);静脉滴注54.2%,肌肉注射35.7%,无统计学差异(P>0.1)。42.1%出现FIB降低;其中国产44.4%,进口40.0%,无显著性差异(P>0.5);静脉滴注47.9%,肌肉注射32.1%,无显著性差异(P>0.1)。颅内出血1例(1.3%)。结论1.L-ASP可影响凝血功能;2.国产和进口、静脉滴注和肌肉注射L-ASP对凝血功能的影响均无显著性差异。

Effects of L-Asparaginase Administration on Coagulation Function in Children with Acute Lymphoblastic Leukemia

Objective To investigate the side effects on coagulation function of L-asparaginase(L-ASP) used to treat acute lymphoblastic leukemia(ALL) patients;to compare the side effects caused by domestic L-ASP and foreign L-ASP,intravenous dosing and intramuscular dosing.Methods The levels of fibrinogen(FIB),activated partial thromboplastin time(APTT) and prothrombin time(PT) of the 76 ALL patiens who were treated with L-ASP were tested after treatment with different products and routes of administration.Results There were 47.4% of patients whose APTT were prolonged,and there was no statistical difference in use of domestic L-ASP and foreign L-ASP(44.4 % vs 50.0%,P>0.5);and so was between intravenous dosing and intramuscular dosing(54.2% vs(35.7%),P>0.1).Forty-two point one percent of the patients had hypofibrinogenemia,which no statistical difference was shown between the use of domestic L-ASP and foreign L-ASP(44.4 % vs 40.0%,P>0.5);and so was between administrations of intravenation and intramusculation(47.9% vs 32.1%,P>0.1).One(1.3%) of them suffered from intracranial hemorrhage.Conclusions 1.(L-ASP) may affect the function of coagulation system,such as prolonged APTT and hypofibrinogenemia.2.There was no statistical difference in side effects of coagulation,in use of domestic L-ASP and foreign L-ASP,intravenous dosing and intramuscular dosing.