双歧杆菌制剂对大剂量甲氨蝶呤治疗急性淋巴

实用儿科临床杂志JApplClinPediatr,Vol.25No.15,Aug.

文章编号:-X()15--02

双歧杆菌制剂对大剂量甲氨蝶呤治疗急性淋巴细胞白血病患儿所致胃肠道不良反应的影响

杜淑旭,唐泓,武万水,孙艳玲,李苗,孙黎明

(医院儿科,北京)

摘要:

目的探讨双歧杆菌制剂对大剂量甲氨蝶呤(HDMTX)治疗ALL患儿所致胃肠道不良反应的影响。

方法参照儿童ALL诊疗建议,将例ALL患儿随机分为2组。治疗组76例。男46例,女30例;年龄2~13岁(中位年龄8岁)。对照组76例。男41例,女35例;年龄2~15岁(中位年龄8.2岁)。2组均为HDMTX强化及预防性治疗中枢神经系统白血病。治疗组在入院时即予双歧杆菌制剂常规口服(金双歧片:2~6岁,每次1片,每日3次;7~15岁,每次2片,每日3次),3d后开始化疗,双歧杆菌制剂与化疗药物间隔2~3h服用,若WBC2.L-1即停用。对照组口服复合维生素B片(2~6岁,每次1片,每日3次;7~15岁,每次2片,每日3次)。治疗期间2组均予相应的对症支持治疗(即水化、碱化及四氢叶酸钙解救)。

结果双歧杆菌制剂对HDMTX化疗引起的消化道不良反应有显著改善作用,治疗组恶心、腹痛、腹泻等消化道症状均较对照组显著减轻,肝功能损害亦较对照组减轻。但对于ALL患儿化疗过程中合并的发热和口腔黏膜损害等症状无明显减轻作用。

结论双歧杆菌制剂可显著改善白血病患儿HDMTX化疗引起的胃肠道不良反应。

关键词:双歧杆菌;微生态制剂;白血病;儿童

中图分类号:R.5文献标识码:A

EffectofBacillusBifidusPreparationonthePreventionofGastrointestinalSideEffectsinChildrenwithAcuteLymphocyteLeukemiaduringHigh-DoseMethotrexateChemotherapy

DUShu-xu,TANGHong,WUWan-shui,SUNYan-ling,LIMiao,SUNLi-ming

(DepartmentofPediatrics,BeijingShijitanHospita,lBeijing,China)

Abstract:ObjectiveToobservetheeffectofbacillusbifiduspreparationonthepreventionofgastrointestinalsideeffectsinchildrenwithacutelymphocyteleukemia(ALL)duringhigh-dosemethotrexate(HD-MTX)chemotherapy.MethodsOnehundredandfifty-twoALLchildrenwererandomlyassignedinto2groupsaccordingtothesuggestionofdiagnosisandtreatmentofALLinchildhood.Therewere76patientsineachgroup.Inthetreatmentgroup,therewere46maleand30female,aged2to13yearsold(themedianagewas8years).Whileinthecontrolgroup,therewere41maleand35female(themedianagewas8.2years).Theyweretreatedwiththesamechemotherapyschedule(HD-MTX),supportivetherapiesandinfectionpreventivemeasures.ALLchildreninthetreatmentgroupwereadditionallygiventhebacillusbifiduspreparation(onetabletfor2to6yearsold,andtwotabletsfor7to15yearsold,3tmiesdaily),iftheirWBCwasmorethan2.L-1.ThoseinthecontrolgroupweregivenvitaminB







































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