酪酸梭菌活菌散对大剂量甲氨蝶呤治疗的急性淋巴细胞白血病患儿免疫功能和化疗相关性腹泻的影响

孟艳; 翟小颖; 张楠; 姜锡娟; 张古英

doi:10.14009/j.issn.1672-2124.2021.09.002

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酪酸梭菌活菌散对大剂量甲氨蝶呤治疗的急性淋巴细胞白血病患儿免疫功能和化疗相关性腹泻的影响

论著 | 更新时间：2022-10-08

- 酪酸梭菌活菌散对大剂量甲氨蝶呤治疗的急性淋巴细胞白血病患儿免疫功能和化疗相关性腹泻的影响
- Effect of Clostridium Butyricum Powder on Immune Function and Chemotherapy-Related Diarrhea in Children with Acute Lymphoblastic Leukemia Treated with High-Dose Methotrexate
- 中国医院用药评价与分析 2021年21卷第9期页码：1028-1031
- 作者机构：
  
  1. 河北省儿童医院药学部
  2. 河北省儿童医院血液肿瘤科
- 作者简介：
- 基金信息：
- DOI：10.14009/j.issn.1672-2124.2021.09.002
  中图分类号： R733.71
- 纸质出版日期：2021，
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孟艳, 翟小颖, 张楠, 等. 酪酸梭菌活菌散对大剂量甲氨蝶呤治疗的急性淋巴细胞白血病患儿免疫功能和化疗相关性腹泻的影响[J]. 中国医院用药评价与分析, 2021,21(9):1028-1031.

MENG Yan, ZHAI Xiaoying, ZHANG Nan, et al. Effect of Clostridium Butyricum Powder on Immune Function and Chemotherapy-Related Diarrhea in Children with Acute Lymphoblastic Leukemia Treated with High-Dose Methotrexate[J]. 2021,21(9):1028-1031.
孟艳, 翟小颖, 张楠, 等. 酪酸梭菌活菌散对大剂量甲氨蝶呤治疗的急性淋巴细胞白血病患儿免疫功能和化疗相关性腹泻的影响[J]. 中国医院用药评价与分析, 2021,21(9):1028-1031. DOI： 10.14009/j.issn.1672-2124.2021.09.002.

MENG Yan, ZHAI Xiaoying, ZHANG Nan, et al. Effect of Clostridium Butyricum Powder on Immune Function and Chemotherapy-Related Diarrhea in Children with Acute Lymphoblastic Leukemia Treated with High-Dose Methotrexate[J]. 2021,21(9):1028-1031. DOI： 10.14009/j.issn.1672-2124.2021.09.002.

摘要

目的:探讨酪酸梭菌活菌散对大剂量甲氨蝶呤治疗的急性淋巴细胞白血病患儿免疫功能和化疗相关性腹泻的影响。方法:选取2018年3月至2021年3月河北省儿童医院血液科收治的首次诊断为急性淋巴细胞白血病的患儿114例

将所有患儿随机分为研究组57例和对照组57例。两组患儿入院后均进行常规诱导治疗。研究组患儿于化疗开始时口服酪酸梭菌活菌散

共治疗14 d。观察两组患儿化疗相关性腹泻的发生率、持续时间和腹泻情况（大便次数、伴随症状等）;并于化疗前后收集患儿的粪便标本

检测二胺氧化酶（DAO）、内皮素（ET）和D-乳酸水平;分别在化疗前后检测患儿的CD4

、CD8

水平

计算CD4

/CD8

;检测患儿治疗前后的免疫球蛋白A（IgA）、免疫球蛋白M（IgM）和免疫球蛋白G（IgG）水平。结果:研究组患儿的化疗相关性腹泻发生率明显低于对照组

腹泻持续时间明显短于对照组

同时研究组患儿的整体脱水情况较对照组明显更佳

差异均有统计学意义（P

0.05）。治疗后

两组患儿的DAO、ET及D-乳酸水平较治疗前明显降低

同时研究组患儿较对照组明显更低

差异均有统计学意义（P

0.05）。治疗后

研究组患儿的IgA、IgM和IgG水平

CD4

、CD8

水平和CD4

/CD8

明显升高;对照组患儿的IgA、IgM和IgG水平

CD4

、CD8

水平明显升高

但CD4

/CD8

明显降低

与治疗前相比的差异均有统计学意义（P

0.05）。治疗后

研究组患儿的IgA、IgM和IgG水平

CD4

、CD8

和CD4

/CD8

明显高于对照组

差异均有统计学意义（P

0.05）。结论:酪酸梭菌活菌散能够有效降低大剂量甲氨蝶呤治疗的急性淋巴细胞白血病患儿的化疗相关性腹泻发生率

改善患儿肠黏膜屏障功能和机体的免疫功能

缩短病程

改善患儿预后。

Abstract

OBJECTIVE: To probe into the effect of Clostridium butyricum powder on immune function and chemotherapy-related diarrhea in children with acute lymphoblastic leukemia treated with high-dose methotrexate.METHODS: Totally 114 children diagnosed with acute lymphoblastic leukemia admitted into Hebei Children ’s Hospital from Mar. 2018 to Mar. 2021 were selected and randomly divided into research group and control group

with 57 cases in each group. Both groups were given conventional inductive treatment after admission. The research group was given Clostridium butyricum powder orally for 14 days before chemotherapy. The incidence

duration and diarrhea（ defection frequency

incidental symptom

etc.） of chemotherapy-related diarrhea in two groups pf children were observed; stool specimens of children were collected before and after chemotherapy

the levels of diamine oxidase（ DAO）

endothelin（ ET） and D-lactate were measured; the CD4

and CD8

levels were measured before and after chemotherapy

and CD4

/CD8

was calculated; the immunoglobulin A（ IgA）

immunoglobulin M（ IgM） and immunoglobulin G（ IgG） levels were measured before and after treatment. RESULTS: The incidence of chemotherapyrelated diarrhea in research group was significantly lower than that of the control group

the duration of diarrhea was also significantly shorter

and the dehydration situation of research group was significantly better than that of the control group

with statistically significant differences（ P

0. 05）. After treatment

the DAO

ET and D-lactate levels of both groups were significantly decreased than those of before treatment

and those of the research group were significantly lower than the control group

with statistically significant differences（ P

0. 05）. After treatment

the IgA

IgM

IgG

CD4

CD8

and CD4

/CD8

levels of research group had been significantly increased; the IgA

IgM

IgG

CD4

and CD8

levels of control group had been significantly increased

while the CD4

/CD8

level was significantly decreased

the differences were statistically significant compared with before treatment（ P

0. 05）. After treatment

the IgA

IgM

IgG

CD4

CD8

and CD4

/CD8

levels of research group were significantly higher than those of the control group

with statistically significant differences（ P

0. 05）. CONCLUSIONS: Clostridium butyricum powder can effectively reduce the incidence of chemotherapy-related diarrhea in children with acute lymphoblastic leukemia treated with high-dose methotrexate

improve the barrier function of intestinal mucosal and immune function of physical body

shorten the course of disease and promote the prognosis of children.

关键词

急性淋巴细胞白血病酪酸梭菌活菌散免疫功能化疗相关性腹泻甲氨蝶呤

Keywords

Acute lymphoblastic leukemiaClostridium butyricum powderImmune functionChemotherapy-related diarrheaMethotrexate

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