Xu S R, Yao E G, Dong Z R, Liu R S, Pan L, Lin F R, Zhang R X, Liu M C, Ma B B, Yin J Q
Research Laboratory of Hematology, Second Affiliated Hospital, Hebei Medical College, Shijiazhuang.
Chin Med J (Engl). 1992 Sep;105(9):713-6.
Plasma ammonia level (PAL) was studied in 43 cases of acute leukemia (AL). PAL was 39.21 +/- 26.2 mumol/L in normal controls and 38.8 +/- 16.6 mumol/L in leukemic patients before chemotherapy. High PAL was found in 40 cases after chemotherapy. Six cases showed clinical manifestations due to severe hyperammonemia, including dizziness, lethargy, confusion, coma and mental changes of various degree, and there was also respiratory alkalosis. After ammonia-trapping therapy, 4 of the 5 patients recovered. The authors believe that high PAL is not uncommon after chemotherapy in leukemic patients. Respiratory alkalosis and unexplained mental and neurologic changes following intensive chemotherapy are useful clues for the diagnosis of hyperammonemia syndrome. Early diagnosis and treatment with ammonia-trapping may improve the rates of remission and survival.
对43例急性白血病（AL）患者的血浆氨水平（PAL）进行了研究。正常对照组的PAL为39.21±26.2μmol/L，白血病患者化疗前为38.8±16.6μmol/L。化疗后40例患者出现高PAL。6例患者因严重高氨血症出现临床表现，包括头晕、嗜睡、意识模糊、昏迷及不同程度的精神改变，同时伴有呼吸性碱中毒。氨捕获治疗后，5例患者中有4例康复。作者认为白血病患者化疗后高PAL并不少见。强化化疗后出现的呼吸性碱中毒以及无法解释的精神和神经改变是诊断高氨血症综合征的有用线索。早期诊断并采用氨捕获治疗可能提高缓解率和生存率。
