A Clinical Study of L-asparaginase on Coagulation Alterations in Children with Acute Lymphoblastic Leukemia_West China Medical Journal

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Yuying Children Hospital,Wenzhou Medical College,Wenzhou 325027,China;

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Keywords：

左旋門冬酰胺酶; 急性淋巴細胞白血病; 凝血

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目的：了解左旋門冬酰胺酶（L-ASP）對兒童急性淋巴細胞白血病凝血功能變化的影響。方法：觀察86例患兒在誘導緩解后治療期間，L-ASP使用前后活化部分凝血活酶時間(APTT)、凝血酶原時間(PT)、凝血酶時間(TT)、纖維蛋白原(FIB)、抗凝血酶Ⅲ(AT-Ⅲ)、D-二聚體變化情況。結果：與用藥前比,用藥結束后一天的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);用藥結束后1周時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，應引起臨床高度重視。Ｌ-Ａｓｐ主要影響蛋白質的合成而引起蛋白質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。

Citation： LI Yuan,WANG Juxiang,ZHOU Haixia,et al.. A Clinical Study of L-asparaginase on Coagulation Alterations in Children with Acute Lymphoblastic Leukemia. West China Medical Journal, 2008, 23(1): 119-120. doi: Copy

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1. [１]顧龍君,孫桂香,盧新天,等.小兒急性淋巴細胞白血病診療建議(第二次修訂草案)[Ｊ].中華兒科雜志,1999,37(5)：305-307．.
2. 張永紅,趙新民,耿蘭增.與左旋門冬酰胺酶治療相關的低蛋白血癥3例[Ｊ].白血病,1997，7(4):242..
3. 唐迪生,毛娟紅.臨床實用藥物及其藥理基礎[Ｍ].上海:復旦大學出版社,1996：322.
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. 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. Shapiro AD,Clarke SL,Christian JM,et al.Thrombosis in children receiving L-asparaginase[J].Am J Pediatr Oncol,1993,15(4):400.

West China Medical Journal

A Clinical Study of L-asparaginase on Coagulation Alterations in Children with Acute Lymphoblastic Leukemia

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