目的 分析接受培门冬酶（PEG-ASP）治疗的B细胞急性淋巴细胞白血病（B-ALL）并发胰腺炎（AP）患儿的临床特点及危险因素。 方法 回顾性分析2021年1月至2023年2月在医院接受PEG-ASP治疗的272例ALL并发AP患儿的一般资料、临床资料、血常规数据、白蛋白浓度和PEG-ASP累计用量，分析患儿性别、年龄、危险分层、累计培门冬酶剂量、血常规指标、白蛋白浓度与胰腺炎进展的相关性。 结果 在272例患儿中，AP发生率为8.5%（23/272），AP与性别、年龄、体质量指数（BMI）、危险分层分布、累计培门冬酶剂量、血红蛋白浓度、血小板计数和单核细胞计数关联无统计学意义（P > 0.05），但与白细胞计数、中性粒细胞计数、淋巴细胞计数、中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值和白蛋白浓度有显著相关性（P < 0.05）。logistic回归分析进一步显示，白细胞计数、中性粒细胞计数、淋巴细胞计数、白蛋白浓度与PEG-ASP相关AP的发生有关（P < 0.05）。ROC分析中发现，白细胞计数、淋巴细胞计数和白蛋白浓度可以提示与PEG-ASP相关AP的发生。 结论 白细胞计数、中性粒细胞计数、淋巴细胞计数、白蛋白浓度是儿童B-ALL并发培门冬酶相关AP的危险因素。尤其是在血常规检查中观察到白细胞计数、淋巴细胞计数和白蛋白浓度检查中白蛋白浓度的异常有助于早期识别B-ALL并发PEG-ASP相关AP的高危患儿。

Objective To analyze the clinical characteristics and risk factors of children with B-cell acute lymphoblastic leukemia （B-ALL） who developed acute pancreatitis （AP） after treatment with pegaspargase （PEG-ASP）. Methods A retrospective analysis was conducted on the general data， clinical data， blood routine data， albumin concentration， and cumulative dose of PEG-ASP of 272 children with ALL complicated with AP who received PEG-ASP treatment in the hospital from January 2021 to February 2023. The correlations between gender， age， risk stratification， cumulative dose of pegaspargase， blood routine indicators， albumin concentration and the progression of pancreatitis were analyzed. Results Among the 272 children， the incidence of AP was 8.5% （23/272）. There was no statistically significant correlation between AP and gender， age， body mass index （BMI）， risk stratification， cumulative dose of pegaspargase， hemoglobin concentration， platelet count and monocyte count （P > 0.05）， but there was a significant correlation with white blood cell count， neutrophil count， lymphocyte count， neutrophil/lymphocyte ratio， platelet/lymphocyte ratio and albumin concentration （P < 0.05）. Logistic regression analysis further showed that white blood cell count， neutrophil count， lymphocyte count and albumin concentration were related to the occurrence of PEG-ASP-related AP （P < 0.05）. ROC analysis found that white blood cell count， lymphocyte count and albumin concentration could predict the occurrence of PEG-ASP-related AP. Conclusions White blood cell count， neutrophil count， lymphocyte count and albumin concentration are risk factors for PEG-ASP-related AP in children with B-ALL. Especially， abnormal white blood cell count， lymphocyte count and albumin concentration in blood routine examination can help identify high-risk children with B-ALL complicated with PEG-ASP-related AP at an early stage.