黄芪注射液对急性淋巴细胞白血病患儿感染因素的影响

目的 探讨黄芪注射液对急性淋巴细胞白血病（ALL）患儿诱导缓解化疗期间感染相关因素的影响。方法 采用随机双盲法将91 例ALL 患儿分为治疗组（47 例）和对照组（44 例），治疗组在诱导缓解化疗的同时给予加用黄芪注射液0.5 mL /kg·d，共35 d，治疗组给予同等剂量生理盐水代替，两组其他支持治疗相同，比较两组诱导缓解化疗结束后患儿感染的发生率、感染持续时间、白细胞及中性粒细胞水平、感染部位及分泌物病原菌培养阳性率等。结果 治疗组47 例患儿中有4 例出现过敏反应后退出实验，研究显示诱导缓解化疗后治疗组患儿的感染发生率低于对照组（P<0.05）；不同感染部位的感染持续时间均低于对照组（均P<0.05）；治疗组化疗后中性粒细胞水平高于对照组（P<0.05）；治疗组呼吸道感染、泌尿道感染、血液感染及皮肤软组织感染发生率均低于对照组（均P<0.05）；感染病原菌以革兰阴性菌为主，感染患儿中治疗组分泌物培养阳性率低于对照组（P<0.05）。结论 黄芪注射液可能在诱导缓解化疗期间减轻了化疗药物对骨髓的抑制，也可能通过提高中性粒细胞水平，从而使ALL 患儿在诱导缓解化疗期间感染发生率降低，感染发生时持续时间缩短。

Effects of Huangqi injection on infection factors in children with acute lymphoblastic leukemia

Objective To investigate the effects of Huangqi injection on the infection factors in children with acute lymphoblastic leukemia (ALL) during remission induction chemotherapy. Methods Ninety-one children with ALL were divided into treatment (n=47) and control groups (n=44) by a randomized double-blind method. During remission induction chemotherapy, the treatment group was given Huangqi injection (0.5 mL/kg·d) for 35 days, while an equal volume of normal saline was used instead in the control group; the other supportive care was the same for the two groups. After remission induction chemotherapy, the incidence of infection, duration of infection, white blood cell and neutrophil counts, site of infection, and positive rate of pathogenic bacteria in secretion were compared between the two groups. Results Four cases in the treatment group dropped out of the study due to allergic reaction. After remission induction chemotherapy, compared with the control group, the treatment group had a significantly lower incidence of infection (P<0.05), a shorter duration of infection at any site (P<0.05), a higher neutrophil count after chemotherapy (P<0.05), and lower incidence rates of respiratory tract infection, urinary tract infection, blood infection, and skin and soft tissue infections (P<0.05). Gram-negative bacteria were the main pathogens. Among the infected children, the positive rate of pathogenic bacteria in secretion was significantly lower in the treatment group than in the control group (P<0.05). Conclusions Huangqi injection may reduce bone marrow suppression caused by chemotherapy drugs and increase neutrophil count during remission induction chemotherapy to reduce the incidence and duration of infection in children with ALL.