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：

左旋门冬酰胺酶; 急性淋巴细胞白血病; 凝血

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目的：了解左旋门冬酰胺酶（L-ASP）对儿童急性淋巴细胞白血病凝血功能变化的影响。方法：观察86例患儿在诱导缓解后治疗期间，L-ASP使用前后活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)、抗凝血酶Ⅲ(AT-Ⅲ)、D-二聚体变化情况。结果：与用药前比,用药结束后一天的PT、APTT、TT均显著延长(P＜0.01);FIB、AT-Ⅲ显著降低(P＜0.01),D-二聚体显著升高(P＜0.01);用药结束后1周时PT、APTT、TT、D-二聚体较用药前差异无显著性,FIB、AT-Ⅲ虽有回升,但仍低于正常(P＜0.01)。结论：L-ASP可引起ALL患儿凝血功能异常，尤其对FIB、AT-Ⅲ影响明显，应引起临床高度重视。Ｌ-Ａｓｐ主要影响蛋白质的合成而引起蛋白质成份的凝血因子减少,从而引起凝血功能障碍,且对纤维蛋白原的合成影响更为显著。

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]顾龙君,孙桂香,卢新天,等.小儿急性淋巴细胞白血病诊疗建议(第二次修订草案)[Ｊ].中华儿科杂志,1999,37(5)：305-307．.
2. 张永红,赵新民,耿兰增.与左旋门冬酰胺酶治疗相关的低蛋白血症3例[Ｊ].白血病,1997，7(4):242..
3. 唐迪生,毛娟红.临床实用药物及其药理基础[Ｍ].上海:复旦大学出版社,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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