大剂量甲氨喋呤治疗儿童急性淋巴细胞白血病的不良反应观察及临床对策  

Observation of clinical side effects of high-dose methotrexate in treating children with acute lymphatic leukemia and clinical countermeasure

作　　者：张琴 

机构地区：[1]湖南省中医药大学附属第一医院药剂科,湖南省长沙市410000

出　　处：《中国现代医药杂志》2009年第11期12-15,共4页Modern Medicine Journal of China

摘　　要：目的研究大剂量甲氨喋呤(HD-MTX,5g/m2)加四氢叶酸钙(CF)解救方案治疗儿童急性淋巴细胞白血病(ALL)的不良反应。方法61例(173例次)的HD-MTX加CF治疗,监测44hMTX血药浓度。观察HD-MTX化疗的各种副作用,并给予相应治疗。结果骨髓抑制、胃肠道反应、皮肤黏膜损害、感染、肝功能损害最为常见,大部分都能在给予相应处理后得到控制。结论HD-MTX(5g/m2)加CF治疗儿童白血病时,不良反应较为常见,但大多能及时控制,在有MTX血药浓度监测的条件下值得临床推广。Objective To study the clinical side effects of high - dose methotrexate （HD-MTX,5g/m^2） and leucovorin （CF） in treating children with acute lymphatic leukemia （ALL）. Methods 61 cases of children with ALL received the treatment with HD-MTX ＋ CF for 173 courses, and detection the methotrexate （MTX） blood concentration of 44 hours.Observing all kinds of clinical side effects,and giving them corresponding treatment. Results myelosuppression, gastrointestinal tract reaction, skin mncosa contamination, infection and liver functional lesion was most common,most of the side effects was controlled after treatmcnt. Conclusion In the course of child ALL treatment with HD-MTX （5g/m2）＋CF ,the side effects are common,but most of then will be controlled in time. In the hospital with blood concentration of MTX ,the treatment with HD-MTX （5g/m^2）＋ CF is worth spreading.

关 键 词：大剂量甲氨喋呤 白血病 淋巴细胞 急性 不良反应 

分 类 号：R733.71[医药卫生—肿瘤] R473.73[医药卫生—临床医学]