大剂量甲氨蝶呤预防小儿中枢神经系统白血病的治疗药物监测  

Therapeutic Drug Monitoring of High Dose Methotrexate on Childhood Central Nervous System Leukemia Prophylaxis

作　　者：范明霞[1] 蔡建春[1] 陈一燕[1] 

机构地区：[1]福建医科大学附属厦门第一医院,厦门361003

出　　处：《海峡药学》2004年第5期104-106,共3页Strait Pharmaceutical Journal

基　　金：厦门市卫生局科研立项课题 ( 2 0 0 10 0 1)

摘　　要：目的 　探讨大剂量甲氨蝶呤 ( methotrexate,MTX)预防小儿神经系统白血病治疗药物监测的临床意义。 方法 　以荧光偏振免疫法( FPIA)检测一定时间下的血清和脑脊液中 MTX的浓度。 结果 　 MTX总剂量为 3 g· m2 ,先予总量的 1/3 3 0 min内鞘内滴入 ,余量 2 3 h匀速静脉滴注 ;3 6h后予以亚叶酸钙 ( calcium folinate,CF )解救。 0 .5、2 4、3 6、48、72 h MTX血清浓度分别为 :79.89、2 2 .5 4、0 .92、0 .3 9、0 .0 95μ mol·L- 1 ,0 .5 h脑脊液浓度为 :0 .3 5 μ mol· L- 1。结论 　治疗药物监测为 HDMTX-CF治疗法提供客观有效的数据 ,对临床应用 HDMTX预防 CNSL的可靠性和安全性有重要的指导意义。OBJECTIVE To investigate the effects of therapeutic drug monitoring of high dose methotrexate on childhood central nervous system leukemia prophylaxis.METHODS The concentrations of MTX in serum and CSF were determined by FPIA.RESULTS One third of MTX with total dose 3g·m -2 was administered within 30 min through intrathecal injection while rest was intravenous drip within 23 hours, 36 hours later CF rescue started. Serum MTX concentrations of 0.5,24,36,48,72h were 79.89,22.54,0.92,0.39,0.095μ mol·L -1 respectively. CSF MTX concentration of 0.5h was 0.35μ mol·L -1 .CONCLUSION Therapeutic drug monitoring provided useful data for HDMTX-CF treatment and confirmed the reliability and safety of the scheme.

关 键 词：大剂量甲氨蝶呤 中枢神经系统白血病 血药浓度 脑脊液浓度 

分 类 号：R969.4[医药卫生—药理学]