摘要
目的探讨大剂量甲氨蝶呤治疗急性淋巴细胞白血病的不良反应分析。方法回顾性分析2019年7月至2019年12月在我院血液科治疗的60例急性淋巴细胞白血病患者的临床资料,均采用大剂量甲氨蝶呤(HD-MTX)治疗,剂量2.0~5.0g/m2,均治疗3个疗程后分析不良反应发生率及临床表现。结果60例患者中,共发生不良反应178例次,骨髓抑制114例次(64.04%)、消化道反应95例次(53.37%)、肝功能损害74例次(41.57%)、感染67例次(37.64%)、黏膜炎42例次(23.60%)、神经系统损害27例次(15.17%)、过敏反应24例次(13.48%)、心脏损害18例次(10.11%)、脱发9例次(5.06%),未见明显肾损伤,也无严重不良反应致死病例。结论大剂量甲氨蝶呤治疗急性淋巴细胞白血病的不良反应较多,临床应加强血药浓度监测,积极对症治疗,以提高疗效及长期无病生存率。
Objective To investigate and analyze adverse reactions of high-dose methotrexate in treatment of acute lymphoblastic leukemia.Methods The paper reviewed and analyzed clinical data of 60 cases acute lymphoblastic leukemia patients in hematology department of our hospital from July 2019 to December 2019.All cases were treated with high-dose methotrexate(HD-MTX)at dose of 2.0 to 5.0 g/m2,incidence of adverse reactions and clinical manifestations were analyzed after 3 treatment courses.Results Among 60 cases,178 showed adverse reactions,114 cases had bone marrow suppression(64.04%),95 cases had gastrointestinal reactions(53.37%),74 cases had liver damage(41.57%),and 67 had infection.(37.64%),42 cases had mucositis(23.60%),27 cases had nervous system damage(15.17%),24 cases had allergic reactions(13.48%),18 cases had heart damage(10.11%),and 9 cases had hair loss(5.06%),there was no obvious kidney injury,no fatal cases of serious adverse reactions.Conclusion High-dose methotrexate has many adverse reactions in treatment of acute lymphoblastic leukemia,it is necessary to strengthen clinical monitoring of blood drug concentration and active symptomatic treatment to improve effect and long-term disease-free survival rate.
作者
张银刚
ZHANG Yin-gang(Pharmacy Department,Yanda Ludaopei Hospital,Sanhe,Hebei,065201)
出处
《智慧健康》
2021年第9期182-184,共3页
Smart Healthcare
