乳铁蛋白在急性淋巴细胞白血病HD-MTX化疗患儿口腔黏膜炎中的应用

摘要

目的：探讨和评价乳铁蛋白在白血病化疗患儿口腔黏膜炎治疗中的作用及其安全性。方法：350例急性淋巴细胞白血病HD-MTX化疗患儿，按病历编号奇偶数分为治疗组和对照组，各175例，治疗组患儿采用乳铁蛋白+其他：亚叶酸钙解救、清洁生理盐水漱口、制霉菌素甘油涂口腔(早、中、晚餐后和睡前)治疗；对照组患儿除给予安慰剂外其他与治疗组一致。当患儿开始化疗时即开始使用，3次/d(早、中、晚饭后)口服。对比记录两组患儿口腔黏膜炎各等级出现及愈合的时间及变化情况，观察使用后的不良反应发生的情况。结果：治疗组与对照组患儿的口腔黏膜炎总发生率无明显差别，但Ⅲ度、Ⅳ度黏膜炎发生率明显低于对照组(P<0.05)；治疗组治愈率和有效率均高于对照组(P<0.05)；各级别的口腔黏膜炎愈合时间也明显低于对照组(P<0.05)。结论：乳铁蛋白对急性淋巴细胞白血病HD-MTX化疗患儿口腔黏膜炎的治疗安全、有效。%Objective:To discuss and evaluate the effect of lactoferrin in the treatment of oral mucositis of leukemia children with chemotherapy and the safety.Method:350 cases of acute lymphocytic leukemia children with HD-MTX chemotherapy were accorded to the medical record number divided into control group and treatment group,175 cases in each group.Besides the leucovorin calcium rescue,clean Physiological saline gargle,and oral care by nystatin glycerol(after meals and before sleeping),the children in the treatment group were given lactoferrin 3 times/d and the control group in addition to giving a placebo were consistent with the treatment group.The incidence changes and healing time of oral mucositis children in various levels were recorded and compared,as well as the adverse reaction.Result:The incidence of oral mucositis in two groups had no obvious difference,but compared with the control group,the incidence ofⅢ,Ⅳlevels mucositis were significantly lower than that the treatment group.The cure rate of treatment group were higher and more efficient,the healing time of the treatment group in various levels were also significantly shorter than that the control group(P<0.05).Conclusion:Lactoferrin applied in oral mucositis of acute lymphoblastic leukemia children with HD-MTX chemotherapy is safe and effective.