超大剂量甲氨蝶呤在骨肉瘤患者化疗中的血药浓度监测  被引量:2

Monitoring the Plasma Concentration of High-dosage of Methotrexate During Chemotherapy for Osteosarcoma

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作  者:许亚[1] 晁娟[1] 黄成琼[1] 

机构地区:[1]江苏徐州市中心医院药剂科,徐州221009

出  处:《海峡药学》2014年第9期152-155,共4页Strait Pharmaceutical Journal

摘  要:目的对大剂量甲氨蝶呤(High dose methotrexate,HD-MTX)治疗骨肉瘤患者的血药浓度进行动态监测,并探讨其临床意义。方法采用均相酶免疫分析法对接受HD-MTX化疗的10例骨肉瘤患者按照需要定时测定甲氨蝶呤的浓度,分析各时间点MTX血药浓度特点及其与不良反应之间的关系。结果测得MTX0h平均峰浓度为(9.4737±3.9473)×10-4moL·L-1,72h平均峰浓度为(9.2743±5.0516)×10-8moL·L-1,其中2例的24hMTX血药浓度和1例48hMTX血药浓度大于中毒浓度,有两例出现毒副反应,对四氢叶酸钙(CF)加大剂量、延长用药时间后,症状消失,所有患者均未发生严重不良发应。结论不同患者MTX各时间点的浓度存在个体差异,应进行血药浓度监测。在血药浓度监测下,及时根据病人实际情况调整CF的解救时间与剂量,使HD-MTX治疗安全可行。OBJECTIVE To monitor the plasma concentration of high-dosage of methotrexate ( HD-MTX) dur-ing chemotherapy in the treatment of patients with osteosarcoma and discuss its clinical significance MEHTODS Ten patients with osteosarcoma who received high dosages of MTX (6g/m2 ) involved in our study.The serum con-centration of MTX was determined according to need at each time point by fluorescence polarization immune assay ( FP IA ) .The relationship between the serum concentration of MTX and the adverse reaction was ana-lyzed.RESULTS The average peak concentration of MTX 0 h was ( 9.4737 ±3.9473 ) ×10 -4 moL · L-1 and the average peak concentration of MTX 72 h was ( 9.2743 ±5.0516 ) ×10 -8 moL · L-1 and.Among them two patients plasma concentration of MTX 24 h and one patient plasma concentration of MTX 48 h were greater than toxic concen-tration,there were two cares of adverse reaction.These symptoms were disappeared after increasing the dose of CF and prolonging treatment.No severe adverse event was observed in all patients.CONCLUSION There is significant variability in the MTX serum levels , and therefore it is clinically important to monitor blood concentration of MTX.App lication of high-dose MTX therapy under the monitoring of blood and MTX concentration is safe and feasi-ble.

关 键 词:大剂量 甲氨蝶呤 骨肉瘤 监测 

分 类 号:R969.4[医药卫生—药理学]

 

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