骨肉瘤患者行大剂量甲氨蝶呤化疗后24小时血药浓度分析及其临床意义  

Analysis of plasma concentration 24 hours after administering high dose methotrexate against osteosarcoma and its clinical significance

作　　者：董迪[1] 张威[1] 宋菲[1] 张清[2] 牛晓辉[2] 甄健存[1] 

机构地区：[1]北京积水潭医院药剂科,北京100035 [2]北京积水潭医院肿瘤科,北京100035

出　　处：《中国医院药学杂志》2016年第13期1092-1095,共4页Chinese Journal of Hospital Pharmacy

基　　金：北京市科技计划课题(大剂量甲氨蝶呤化疗应用及严重毒副作用处理临床规范的建立)(编号:Z131107002213029)

摘　　要：目的:根据使用大剂量甲氨蝶呤进行化疗的骨肉瘤患者24 h血药浓度值(C24h),对有可能发生延迟排泄的患者进行提前预警,与临床协作对患者后续的治疗方案及时进行调整,并且为今后制定更加合理的MTX解救流程提供数据支持。方法:对某院2010年8月至2015年8月进行甲氨蝶呤血药浓度监测的骨肉瘤患者的C24h数据共3 515例进行分析,并研究C24h与延迟排泄的关系。结果:C24h具有一定规律性,与甲氨蝶呤血药浓度达标所需时间成正相关。建立C24h危急值报告制度对调整后续治疗方案及患者用药安全预警具有一定实际意义。结论:应通过监测C24h及时调整后续治疗方案,并对高血药浓度患者尽早处理,防止对患者造成严重损伤。OBJECTIVE According to plasma concentration 24 hours after administering high dose methotrexate（C24h）,to prewarn a high risk of delayed methotrexate excretion for the purpose that adjustment of therapeutic scheme should be done in time,and provide statistical data to develop reasonable rescue process.METHODS A total of 3 515 results of plasma concentration were analyzed to find out relationship between value of plasma concentration and risk of delayed methotrexate excretion.RESULTS C24 hhad a regularity that it positively correlated with time required for plasma concentration reaching the standard,which had a clinical significance to adjustment of therapeutic scheme and pre-warning medication safety.CONCLUSION C24 h monitoring can be utilized to timely adjust therapeutic scheme,prevent serious damage to patients who have high methotrexate plasma concentrations.

关 键 词：骨肉瘤 甲氨蝶呤 治疗药物监测 用药监护 延迟排泄 

分 类 号：R969[医药卫生—药理学]