甲氨蝶呤血药浓度动态监测在骨肉瘤治疗中的应用  

Applications of dynamic monitoring serum methotrexate in osteosarcoma treatment

作　　者：张翠欣[1] 丁国瑾[1] 刘红卫[1] 赵驻军[1] 邓瑾[2] 

机构地区：[1]河北医科大学第三医院药剂科,石家庄市050051 [2]河北医科大学药学院

出　　处：《临床合理用药杂志》2009年第22期21-22,共2页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的采用荧光偏振免疫分析(FPIA)法监测大剂量甲氨蝶呤(MTX)化疗的骨肉瘤患者血清中MTX浓度,确定大剂量MTX对骨肉瘤患者进行辅助化疗的个体化用药方案。方法对15例肝、肾功能正常的骨肉瘤患者采用大剂量MTX 14g/m2配合顺铂及异环磷酰胺(AP-HD-MTX-IFO)的综合治疗方案,于给药后不同时间取血,采用FPIA法测定血清MTX浓度,应用DAS 2.1.1软件计算药代动力学参数,结合患者生化指标及临床表现,调整亚叶酸钙(CF)的解救时间和剂量。结果确定了每个患者的最佳治疗方案,15例患者均未出现严重不良反应。结论应用FPIA法可以准确、快速地动态监测MTX血药浓度,得出大剂量MTX在每个骨肉瘤患者体内的药代动力学数据,使骨肉瘤患者的治疗更加安全、有效。Objective To explore the reasonable and individual treatment plan in osteosarcoma by determining serum methotrexate（MTX）concentration in patients receiving high-dose MTX therapy（HDMTX）of osteosarcoma by fluorescence polarization immunity analytical method（FPIA）and clinical manifestation.Methods Dosage regimen：AP-HD-MTX-IFO.Different time blood samples from 15 patients receiving HDMTX（14 g/m2 were determined by FPIA,concentration-time data were analysed by DAS 2.1.1.Adjusted the dosage regimen of calcium folinate by clinical data and manifestation. Results The security and rationality of dosage regimen was determined by the serum concentration data and clinical manifestation. Conclusion The determination of serum methotrexate（MTX） is convenient and exact at FPIA. The dosage regimen adjusting by clinical data and manifestation is rationality.

关 键 词：大剂量甲氨蝶呤化疗 荧光偏振免疫分析法 骨肉瘤 

分 类 号：R738.1[医药卫生—肿瘤]