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为了研究门冬酰胺酶(ASP)治疗血液肿瘤时致高甘油三酯血症(HTG)的发生率、临床特点和治疗,以引起临床对该副反应的重视,对24例儿童和成人急性淋巴细胞白血病(ALL)、淋巴母细胞淋巴瘤和NK/T细胞淋巴瘤患者接受了含ASP的联合化疗方案治疗,测定治疗前后的血胆固醇和甘油三酯(TG)水平,确定血脂异常的发生率和特点。24例患者共接受36个周期含ASP的联合方案化疗,2例次出现HTG,发生率为5.6%。2例均为成人ALL,均在初次缓解后4和5个月,再次使用ASP进行巩固治疗时出现HTG,峰值TG分别为32.57和15.77 mmol/L。1例同时伴有下肢剧烈疼痛。停用ASP并加用胰岛素静脉滴入治疗,9~11 d后血脂均恢复正常。初步研究结果提示,接受ASP治疗的血液肿瘤患者有发生HTG的危险,尽管此种HTG在停药多后多可恢复,但可继发胰腺炎、高黏滞综合征或血栓。因而ASP治疗时应常规监测血TG水平。
In order to investigate the incidence, clinical features and treatment of hypertriglyceridemia (HTG) in the treatment of hematologic tumors with asparaginase (ASP) in order to arouse clinical emphasis on this side effect, 24 children and adults with acute lymphoid Patients with ALL, lymphoblastic lymphoma and NK / T cell lymphoma were treated with a combination chemotherapy regimen containing ASP. Blood cholesterol and triglyceride (TG) levels were measured before and after treatment to determine the incidence of dyslipidemia And features. Twenty-four patients received a total of 36 cycles of chemotherapy with aspirin and 2 HTGs with a 5.6% incidence. Both of them were adult ALL, all of which were at 4 and 5 months after initial remission. HTG was again treated with ASP for consolidation therapy with peak TG values of 32.57 and 15.77 mmol / L, respectively. 1 case accompanied by severe pain in lower limbs. Disable ASP and add insulin intravenous infusion, 9 ~ 11 d after the blood lipids were back to normal. Preliminary findings suggest that patients with hematologic tumors treated with ASP are at risk for developing HTG. Although this HTG is more regainable after discontinuation of drug, pancreatitis, hyperviscosity syndrome, or thrombosis may occur. Therefore, routine treatment of ASP blood glucose levels should be monitored.