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JNCI:急性淋巴细胞白血病患儿治疗方案损害认知功能

2012-09-05 丁香园 丁香园

虽然预防性头部放疗会对认知造成影响,但在20%的急性淋巴细胞白血病的(ALL)患儿中仍然应用该治疗方案。Conklin等在JNCI最新的在线期刊上发表的相关研究旨在证实急性淋巴细胞白血病治疗方案对患儿认知功能的影响。 研究所纳入的患者来自于St Jude ALL Total Therapy Study XV,该研究不对患者都进行预防性头部放疗,并在治疗完成后120周全面评估这243名患者的认知功

虽然预防性头部放疗会对认知造成影响,但在20%的急性淋巴细胞白血病的(ALL)患儿中仍然应用该治疗方案。Conklin等在JNCI最新的在线期刊上发表的相关研究旨在证实急性淋巴细胞白血病治疗方案对患儿认知功能的影响。

研究所纳入的患者来自于St Jude ALL Total Therapy Study XV,该研究不对患者都进行预防性头部放疗,并在治疗完成后120周全面评估这243名患者的认知功能。应用χ2检验比较ALL组中低于平均分的患者和正常对照。应用单变量Logistic回归分析估计强化化疗的效果(治疗组)、确诊的年龄和性别。所有的统计皆为双侧检验。

总体而言,ALL组患者在持续注意上表现显著低于平均水平,但其对智力、学习表现和记忆方面的影响无显著统计学差异。与接受低强度化疗的患者相比,接受高强度化疗的患者在信息处理速度和学习能力(数学推理能力、阅读能力和拼写能力)上的表现均存在低于平均水平的风险。同时对家长的调查显示这些儿童更容易出现过度活动和存在学习障碍。确诊年龄和性别对患者的认知功能无显著影响。

省略头部放射治疗能帮助保存患儿的整体认知功能,但是单独应用化疗并非对认知完全没有损害。对医务人员的教育和治疗方法的发展需着眼于治疗的患儿早期的认知损害及对认知的后期影响。

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