甲氨蝶呤治疗小儿急性白血病时血液和脑脊液中浓度监测及不良反应  

Monitoring of concentration in serum and cerebrospinal fluid of high-dose methotrexate and it's adverse drug reaction in acute lymphocyte leukemia children

作　　者：唐薇[1] 王雅香[2] 张东林[3] 江秀华[1] 廖淑清[1] 张瑛[2] 

机构地区：[1]昆明医学院第一附属医院药剂科,昆明650032 [2]昆明医学院第一附属医院儿科,昆明650032 [3]昆明医学院药学系

出　　处：《中国临床药学杂志》2002年第3期150-152,共3页Chinese Journal of Clinical Pharmacy

摘　　要：目的 :探讨甲氨蝶呤 (MTX)用于小儿急性淋巴细胞白血病 (ALL)化疗时 ,剂量增至 4g·m-2 是否更为有效且安全。方法 :对 2个剂量组 (3g·m-2 ,4g·m-2 )各 15例次进行MTX血药浓度及不良反应发生率的比较。血药浓度测定方法采用荧光偏振免疫法 (FPIA)。结果 :4g·m-2 剂量组静滴结束时 (12h)血药浓度显著高于 3g·m-2 剂量组 (P <0 0 5 ) ,不同个体间血药浓度及脑脊液浓度水平差异较大 ,2剂量组的不良反应发生率无明显差异 (P >0 0 5 )。结论 :在进行MTX血药浓度监测的情况下 ,要掌握好救援时间和剂量 ,采用 4g·m-2AIM: To investigate if the dosage of methotrexate (MTX) can be increased to 4 g·m -2 with better effect and security in chemotherapy of children with acute lymphocyte leukemia (ALL). METHODS: Compared the serum concentration of MTX and the adverse drug reaction incidence between 2 groups of high-dose MTX (3 g·m -2, 4 g·m -2) with each 15 cases. The concentration was monitored by using the method of fluorescence polarization immunoassay (FPIA). RESULTS: At the time of MTX infusion completed (12 h), the serum concentration of MTX of the 4 g·m -2 group was remarkably higher than that of the 3 g·m -2 (P<0.05). The concentration in serum and cerebrospinal fluid had great imparity among individuals. There was no difference in the adverse drug reaction incidence between the 2 groups (P>0.05). CONCLUSION: The MTX dosage of 4 g·m -2 can be tolerated with the serum concentration of MTX monitored and in control of rescuing time and dosage rationally.

关 键 词：大剂量甲氨蝶呤 血药浓度 急性淋巴细胞白血病 不良反应 儿童 ALL 

分 类 号：R733.7[医药卫生—肿瘤]