髓母细胞瘤患儿甲氨蝶呤的血药浓度与肾功能的相关性研究  

Correlation analysis between methotrexate serum concentration and renal function in children with medulloblastoma

作　　者：时正媛[1,2,3] 续茜桥 杨春静 杨璐 SHI Zheng-yuan;XU Xi-qiao;YANG Chun-jing;YANG Lu(Department of Pharmacy,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Beijing Key Laboratory of Bio-characteristic Profiling for Evaluation of Rational Drug Use,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Joint Laboratory for International Cooperation of Bio-characteristic Profiling for Evaluation of Clinical Rational Drug Use,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院药剂科,北京100038 [2]首都医科大学附属北京世纪坛医院临床合理用药生物特征谱学评价北京市重点实验室,北京100038 [3]首都医科大学附属北京世纪坛医院临床合理用药生物特征谱学评价国际合作联合实验室,北京100038

出　　处：《中国新药杂志》2021年第8期701-704,共4页Chinese Journal of New Drugs

基　　金：国家“重大新药创制”科技重大专项资助项目(2017ZX09301040);国家自然科学基金面上基金资助项目(81773891)。

摘　　要：目的:分析髓母细胞瘤患儿使用大剂量甲氨蝶呤(HD-MTX)化疗的血药浓度与肾损伤的相关性。方法:选择大剂量甲氨蝶呤化疗的髓母细胞瘤患儿139例(共计监测782例次)为研究对象,回顾性收集患者的24 h与42 h血药浓度、血肌酐、血尿素氮与尿酸治疗前后实验室检查结果,分析肾功能指标变化与血药浓度之间的相关性。结果:MTX给药后24 h血清中MTX浓度与患者化疗后尿酸值呈正相关,与肌酐清除率呈负相关,而与血肌酐值、尿素氮值无关。MTX给药后42 h血清中MTX浓度与患者化疗后血肌酐、尿素氮值呈正相关,而与肌酐清除率、尿酸值呈负相关(P<0.001)。结论:MTX血药浓度监测对于MTX化疗造成的肾损害有一定的预测作用。Objective:To analyze the correlation between blood drug concentration and kidney injury in children with medulloblastoma treated with high-dose methotrexate(HD-MTX)chemotherapy.Methods:A total of 139 children with medulloblastoma treated with high-dose methotrexate chemotherapy were selected and their 782 blood drug concentrations,basic data,and laboratory examination results before and after treatment were retrospectively collected to analyze the correlation between changes in kidney function indicators and blood drug concentration.Results:Serum MTX concentrations at 24 h post medication were positively correlated with uric acid level,negatively correlated with creatinine clearance,but not with serum creatinine and blood urea nitrogen levels.Serum concentrations of MTX at 42 h post medication were positively correlated with serum creatinine and blood urea nitrogen levels,negatively correlated with creatinine clearance and blood urea nitrogen level.Conclusion:Monitoring of MTX serum concentration can predict the kidney damage caused by MTX chemotherapy.

关 键 词：甲氨蝶呤 髓母细胞瘤 血药浓度 肾损伤 

分 类 号：R979.1[医药卫生—药品]