水化对预防大剂量甲氨喋呤治疗小儿白血病所致不良反应的临床意义(附75例报告)  

Clinical significance of hydration in preventing the toxic side effects of high-dose methotrexate on acute leukemia in children

作　　者：乐少华[1] 陈燕惠[1] 李健[1] 

机构地区：[1]福建医科大学附属协和医院儿科,350001

出　　处：《福建医药杂志》2009年第2期11-14,共4页Fujian Medical Journal

摘　　要：目的观察大剂量甲氨喋呤(HD-MTX)治疗小儿急性淋巴细胞白血病(ALL)产生的不良反应,研究水化在预防HD-MTX不良反应中的临床意义。方法75例ALL患儿各观察2次HD-MTX治疗,按水化完成情况分为充分水化与未充分水化组,比较两组口腔黏膜炎、中性粒细胞减少的发生率及WBC、PLT、ALT的变化。结果未充分水化组口腔黏膜炎、中性粒细胞减少发生率较充分水化组高且反应程度较重(P<0.05),而WBC、PLT下降和ALT升高较充分水化组明显(P<0.05)。结论HD-MTX化疗有一定的不良反应,在没有条件监测MTX血药浓度的医院,水化对预防HD-MTX不良反应的发生尤为关键,充分水化可有效降低HD-MTX毒副反应的发生率。Objective To observe the toxic side effects of high dose methotrexate （HDMTX） on acute lymphoblastic leukemia （ALL）, and to study the role of adequate hydration in preventing the complications. Methods All the 75 children were observed in two courses of HD-MTX treatment. One hundred and fifty times of treatment were divided into adequate hydration group and inadequate group with different hydration. The rate of mucositis and neutropenia, and the variation of WBC, PLT and AI,T were compared between adequate group and inadequate hydration group. Results HD-MTX compared to ade quate hydration group, the incidence rate of mucositis and neutropenia were higher, the variation of WBC and PLT were de creased significantly, and the variation of ALT were increased significantly in inadequate hydration group （P〈0.05）. Conclusion The side effects of HD-MTX are frequent after chemotherapy. In the hospital without blood concentration of MTX, adequate hydrate is the most measured. Adequate hydration can reduce the rate of the toxic reactions of HD-MTX effectually.

关 键 词：甲氨喋呤 白血病 不良反应 水化 

分 类 号：R733.7[医药卫生—肿瘤]