大剂量甲氨蝶呤治疗儿童急性淋巴细胞白血病安全性临床观察  

The Clinical Observation on the Safety of the High-dose Methotrexate in the Treatment of the Children with Acute Lymphoblastic Leukemia

作　　者：屈丽君[1] 汪俭[1] 吴蓓[1] 王成军[1] 

机构地区：[1]安徽省立儿童医院,安徽合肥230051

出　　处：《儿科药学杂志》2011年第5期17-19,共3页Journal of Pediatric Pharmacy

摘　　要：目的:观察大剂量甲氨蝶呤(MTX)连续24 h持续静脉输注治疗儿童急性淋巴细胞白血病临床安全性。方法:50例急性淋巴细胞白血病患儿进行196例次大剂量甲氨蝶呤连续24 h持续静脉输注,第42 h亚叶酸钙解救,检测44 h、68 h MTX浓度,观察不良反应发生情况。结果:不良反应表现为口腔粘膜损害、皮肤损害、消化道症状、肝功能损害和1～2度白细胞减少,无严重不良反应发生。95.5%的患儿44 h血药浓度<1.0μmol/L。结论:大剂量甲氨蝶呤加亚叶酸钙解救治疗儿童急性淋巴细胞白血病安全性好。个别患儿出现排泄延迟,通过检测MTX血药浓度,增加亚叶酸钙解救次数,可防止严重不良反应发生。Objective： To observe the safety of high-dose methotrexate（HD-MTX） infused intravenously for 24 h in the treatment of the children with acute lymphoblastic leukemia（ALL）.Methods： HD-MTX was infused for 24 h in 50 cases of children with acute lymphoblastic leukemia followed by calcium folinate（CF） for rescue at the 42nd hour,and then at the 44th,68th hour,the blood concentration of MTX was examined and the incidence rate of the side effects were observed.Results： The adverse reaction appeared as digestive tract symptoms,liver function damage,grade 1 to 2 leucopenia,oral mucosal and skin diseases,no serious adverse reactions observed.The children with blood MTX concentration of 95.5% at the 44th hour were less than 1.0 μmol/L.Conclusions： The tolerance of HD-MTX in addition to the rescuing and treating children with ALL was good,although a few children appared the delayed excretion of MTX.Through monitoring the blood concentration of MTX and increasing the times of CF administration,the serious adverse reaction can be avoided.

关 键 词：儿童 急性淋巴细胞白血病 甲氨蝶呤 安全性 

分 类 号：R725.5[医药卫生—儿科]