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目的检测应用三氧化二砷治疗白血病患者的尿中砷化物水平,探讨砷代谢情况及对肝功能、血常规的影响。方法观察12例住院应用三氧化二砷治疗的患者,于用药前、用药后10 d及20 d留取晨尿,检测尿中无机砷(iAs)、一甲基砷(MMA)和二甲基砷(DMA)的水平,并检测肝功能及血常规等各项临床指标,采用重复测量的方差分析及相关分析进行研究。结果治疗前、治疗后10 d及20 d尿中iAs、MMA、DMA水平比较,差异均有统计学意义(P<0.05)。患者治疗前、治疗后10 d及20 d的总蛋白、清蛋白、天冬氨酸氨基转移酶水平比较,差异均无统计学意义(P>0.05);而丙氨酸氨基转移酶(ALT)水平比较,差异有统计学意义(P<0.05)。患者治疗前后血常规各项指标水平比较,差异均无统计学意义(P>0.05)。患者治疗后10 d尿中iAs水平与ALT水平呈正相关(r=0.65,P<0.05)。结论三氧化二砷治疗后患者ALT水平与无机砷水平有关,而对肝脏其他功能及血液系统无不良反应,为一种安全有效的药物。监测尿中砷化物的水平可有效反映砷在体内的代谢情况,必要时可进行驱砷治疗。
Objective To detect the levels of arsenic in urine of patients with leukemia treated with arsenic trioxide and to investigate the effects of arsenic metabolism and liver function and blood routine. Methods Twelve patients who were treated with arsenic trioxide in hospital were enrolled in this study. Morning urine was collected before medication and 10 d and 20 d after treatment. Urinary inorganic arsenic (iAs), monomethyl arsenic (MMA) and dimethyl arsenic (DMA) ), And to detect various clinical indexes such as liver function and blood routine. The variance analysis and correlation analysis of repeated measurement were used to study. Results Before treatment, the levels of iAs, MMA and DMA in urine on the 10th and 20th day after treatment were significantly different (P <0.05). The levels of total protein, albumin and aspartate aminotransferase in the patients before treatment, 10 d and 20 d after treatment were not significantly different (P> 0.05); however, the levels of alanine aminotransferase (ALT) The difference was statistically significant (P <0.05). Before and after treatment of patients with various indicators of blood levels, the difference was not statistically significant (P> 0.05). There was a positive correlation between urinary iAs level and ALT level after treatment (r = 0.65, P <0.05). Conclusion The ALT level in patients with arsenic trioxide after treatment is related to the level of inorganic arsenic, but no adverse reactions to other liver functions and blood system. It is a safe and effective drug. Monitoring the level of arsenic in urine can effectively reflect the metabolism of arsenic in the body, if necessary, arsenic treatment can be carried out.