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目的观察长效核黄素对大剂量甲氨喋吟(HD-MTX)化疗常见毒副反应的预防效果。方法1996年10月至2004年8月期间,26例患儿共接受72个疗程HD-MTX化疗(3.0g/m2,持续静滴12 h),观察组41个疗程同时应用长效核黄素,对照组31个疗程不用。根据WHO抗癌药物毒副反应分度标准,观察比较两组患儿治疗后口腔黏膜损害、肝功能变化及骨髓抑制程度。结果观察组口腔黏膜损害发生率(12.2%,5/41)明显低于对照组(45.2%,14/31),且观察组损害程度较重(P=0.002)。两组间肝功能变化及骨髓抑制程度差异无显著性。结论HD-MTX化疗中应用长效核黄素可有效预防口腔黏膜损害,对肝功能损害及骨髓抑制无明显预防作用。
Objective To observe the preventive effects of long-acting riboflavin on toxic and side effects of high-dose methotrexate (HD-MTX) chemotherapy. Methods From October 1996 to August 2004, 26 children received 72 courses of HD-MTX chemotherapy (3.0g / m2, continuous intravenous infusion for 12 hours). In the observation group, 41 courses were treated with long-term riboflavin , Control group 31 courses do not. According to the standard of WHO anti-cancer drug toxicity index, oral mucosal damage, changes of liver function and bone marrow suppression were observed and compared between the two groups. Results The incidence of oral mucosal injury in the observation group was significantly lower than that in the control group (12.2%, 5/41) (45.2%, 14/31), and the severity of the damage in the observation group was significant (P = 0.002). There was no significant difference in the changes of liver function and bone marrow suppression between the two groups. Conclusion The long-term use of riboflavin in HD-MTX chemotherapy can effectively prevent oral mucosal injury and has no significant preventive effect on liver dysfunction and myelosuppression.