【摘要】 目的 观察大剂量阿糖胞苷强化治疗急性髓性白血病的并发症。方法 观察大剂量阿糖胞苷总量(10～18g)强化治疗36例诱导缓解后的急性髓性白血病的毒副反应：骨髓抑制、眼毒性、黏膜溃疡、肺损、肝损、肾损、消化道损害等。结果27.8%的患者出现肝损害，2.78%的患者出现心脏毒性，11.1%的患者出现眼毒性，27.8%的患者出现皮肤过敏，69.4%的患者出现消化道反应，11.1%的患者有不同程度的脱发，36例患者均无肾功损害。在骨髓严重抑制期66.66%患者出现发热， 55.5%的患者出现病灶不明显的发热，11.1%的患者出现肺部感染，11.1%的患者出现腹泻，5.55%的患者出现肛周感染，25%的患者出现口腔溃疡，58.3%的患者出现皮肤出血，鼻出血占2.7%，牙龈出血占16.66%，消化道出血占2.7%，均给予对症治疗后逐渐恢复。血小板在化疗结束后平均第9.08天最低，白细胞在化疗结束后平均第9.5天最低。结论 大剂量阿糖胞苷作为急性髓性白血病的强化治疗和中枢白血病(CNSL)的防治疗效明显，毒副反应可以耐受，对症处理后可恢复正常。

    【关键词】 大剂量阿糖胞苷；急性非淋巴细胞白血病；化疗；并发症

    Clinical study of the complications of the intensive chemotherapy with high dose cytarabine in acute myelogenous leukemia

    LU Qing，WU Xiao-xiong，DA Wan-ming，et al.

    Department of Hematology, Friendship Hospital of Wulumuqi，Xinjiang 830049,China

    【Abstract】 Objective To investigate the complications of intensive chemotherapy of high dose cytarabine (HDAraC) in patients with acute myelogenous leukemia(AML).Methods Clinical observations were made in 36 patients with acute myelogenous leukemia receiving intensive chemotherapy of HDAraC (10～18g) when they obtained complete remission(CR) after induction therapy. Results Reactions of digestive tract such as nausea and vomiting occurred in 69.4% of the patients. The toxicity to the liver were found in 27.8% and skin rashes appeared also in 27.8% of the patients. Eleven point one percent of the patients had different degrees of alopecia and toxicity of oculi, while the toxicity to the heart was only 2.78%. No toxicity to kindey appeared in all the patients involved. Fever occurred in 66.66% during severe marrow suppression, including lung infection(11.1%), diarrhea(11.1%), oral infection(25%)and perianal infection(5.55%), and 55.5% patients who had fever were found no obvious infection site. Skin hemorrhage, nasal hemorrhage and bleeding gums were 58.3%, 2.7% and 16.66% respectively. All the patients who suffered the toxicity and complications were recovered after treatments.Conclusion High dose Ara-C is being widely accepted as intensive chemotherapy of AML according to its curative effects and prophylaxis effect to central nervous system leukemia. The complications and adverse effects of high dose Ara-C in our study can be tolerated and recovered after comprehensive treatments. ......