摘要
目的:通过对大剂量甲氨蝶呤(HD-MTX)治疗小儿急性淋巴细胞白血病血药浓度的分析,探讨甲氨蝶呤血药浓度监测的临床意义。方法:采用荧光偏振免疫法(FPIA)监测接受大剂量甲氨蝶呤化疗的32例急性淋巴细胞白血病患儿血药浓度。结果:在应用HD-MTX开始后72h、90h时MTX血药浓度的变异系数分别为211.76、128.57;应用后72h血药浓度大于1μmol/L有4例;应用后90h血药浓度大于0.1μmol/L2例且患儿出现了口腔粘膜溃疡。所有患儿无不可逆的严重不良反应。结论:患儿应用MTX后血药浓度个体差异较大,通过血药浓度监测可以调整甲酰四氢叶酸钙(CF)的解救时间和剂量,有效防止严重不良反应的发生,保证化疗的有效性和安全性。
Objective：To explore the clinical significance of monitoring the serum concentration of methotrexate in high-dose methotrexate （HD-MTX） treatment for children with acute lymphoblastic leukemia. Methods： 32 children with acute lymphoblastic leukemia who received YID-MTX were involved in this study and the concentrations of MTX were tested by fluorescence polarization immunoassay. The blood samples were collected timely and the blood serum concentration of MTX was determined. Results： 72 h and 90 h after the application of HD-MTX, the coefficient of variation for serum MTX concentration was 211.76%, 128.57%, respectively. 72 h after application, there were 4 cases with serum concentration 〉 1 μmol/L; 90 h after application there were 2 cases with serum concentration 〉0. 1 μmol/L having serious oral mucosal ulcers. None of serious irreversible adverse effects were observed among all children. Conclusions： MTX concentration in serum had great difference between individuals, though a few children appeared the excretion retarded. A close monitoring of the serum concentration helps in timely adjustment of the saving time and the dosage of calcium folinate （ CF）, avoid serious adverse reaction and ensure the efficacy and safety of the chemotherapy.
出处
《儿科药学杂志》
CAS
2008年第6期5-7,共3页
Journal of Pediatric Pharmacy
关键词
甲氨蝶呤
血药浓度监测
急性淋巴细胞白血病
Methotrexate
Serum concentration monitoring
Acute lymphoblastic leukemia
作者简介
王来成（1964～），男，大学本科，副主任药师，主要从事临床药学研究，E—mail：wanglch6419@tom．com。
