大剂量甲氨喋呤对儿童急性白血病肾功能影响的探讨

为探讨大剂量甲氨蝶呤治疗儿童急性白血病对肾功能的影响及临床意义。采用HITACHI 7170A全自动生化仪测定 2 5例白血病患儿HDMTX冲击化疗前后测血清尿素氮 (BUN)、肌酐 (Cr)、 谷氨酰转换酶 ( GT)、碱性磷酸酶 (ALP) ;血、尿 β 2微球蛋白 ( β 2 MG) ;分别选取MTX治疗前一天 ,前 1小时 ;后 1、12、2 4、48、72小时和治疗后 1周 8个点为观察时象留取随意尿 3ml ,同时用尿肌酐校正 ,测定尿微量白蛋白(MA)、尿免疫球蛋白G(IgG)及N 已酰 β D 氨基酸葡萄糖苷酶 (NAG)、 谷氨酰转换酶 ( GT)、碱性磷酸酶 (ALP)、亮氨酸酶 (LAP)、尿酸 (UA)。对照组 98例 ,用MA Cr、IgG Cr、NAG Cr、 GT Cr、ALP Cr、LAP Cr、UA Cr表示。统计学处理采用SAS软件统计。结果 ,治疗前后血BUN、Cr、ALP、 GT、UA等均无显著性差异 (P >0 0 5 )。治疗前后血、尿β 2 M比较 ,治疗后血 β 2 M较治疗前增高 (P <0 0 5 ) ;尿 β 2 M无明显的改变 (P >0 0 5 )。治疗前的尿微量蛋白及尿酶与正常对照组的比较 ,两组比较无显著性差异。MTX治疗前一天 ,前 1小时 ;后 1、12、2 4、48、72小时和治疗后 1周 8个点测定MA Cr、IgG Cr、NAG Cr、 GT Cr、ALP Cr、LAP Cr、UA Cr的结果提示各指标组内均无显著性差异 ;各测定点及测定?

The renal toxicity in high dose methotrexate chemotherapy for acute leukemia in children

Objective To evaluate diagnostic basis and the significance in clinical applicat ion for early renal disease in high dose methotrexate chemotherapy for acute leu kaemia. Methods Adopt random urinary 3 ml(Urinary PH<8 0), Adopt submit liquid of centrifugal urinary and urinary creatinine was determined, Urinary microalbu min(MA)? Urinary immune globin G(IgG)?N-acety β-D-glucosaminidase(NAG)? -glutamin transformenzyme(-GT)?alkaline phosphoesterase(ALP)?leucine enzym e(LAP) was determined for 98 case in the controls and 25 case in the diseases af ter MTX chemotherapy. Select the MTX chemotherapy front 1 day?front 1 h?after 1?12?24?48?72 h?1 week 8 point observed times determine MA/Cr?IgG/Cr?NAG/ Cr?-G T/Cr?ALP/Cr?LAP/Cr?UA/Cr. Statistics deal with SAS software. Results (1) The renal function changes were not evidence in acute leukaemia(ALL) remittence peri od(CR).(2)The renal function changes were evidence and volatility after HDMTX c h emotherapy, the harm was more distinct after 1 hour of chemotherapy and was temp orary of renal tubules.(3) The meothod is sensitive and reliable to combined uri nary microprotein and urinary enzyme for diagnose of early renal diseases.