Nguyen D L, Wilson D A, Engelman E D, Sexauer C L, Nitschke R
South Med J. 1987 Sep;80(9):1133-6. doi: 10.1097/00007611-198708090-00015.
The clinical, laboratory, and ultrasonographic findings in children receiving L-asparaginase therapy were retrospectively reviewed and correlated to determine the diagnostic reliability and clinical usefulness of serial pancreatic sonograms in detecting L-asparaginase-induced pancreatitis. A total of 217 sonograms were obtained in 92 patients. Six of the 92 (6.5%) had L-asparaginase-induced pancreatitis. The diagnosis of pancreatitis was based solely on clinical symptoms in three patients, on clinical and laboratory findings in two, and on sonographic and laboratory findings in one. No confirmed cases of pancreatitis were detected solely by ultrasonography before clinical or laboratory evidence was obtained. Sonograms were useful only in confirming clinical and/or laboratory evidence of pancreatitis, but were of no value in making the early or preclinical diagnosis of drug-induced pancreatitis. We have discontinued the practice of obtaining routine serial pancreatic sonograms in children receiving L-asparaginase at our institution.
我们对接受L-天冬酰胺酶治疗的儿童的临床、实验室及超声检查结果进行了回顾性分析，并相互关联以确定系列胰腺超声检查在检测L-天冬酰胺酶诱导的胰腺炎方面的诊断可靠性和临床实用性。共对92例患者进行了217次超声检查。92例患者中有6例（6.5%）发生了L-天冬酰胺酶诱导的胰腺炎。3例患者的胰腺炎诊断仅基于临床症状，2例基于临床和实验室检查结果，1例基于超声和实验室检查结果。在获得临床或实验室证据之前，单纯通过超声检查未发现确诊的胰腺炎病例。超声检查仅有助于确认胰腺炎的临床和/或实验室证据，但对药物性胰腺炎的早期或临床前诊断没有价值。我们已停止在本机构对接受L-天冬酰胺酶治疗的儿童进行常规系列胰腺超声检查的做法。
