摘要
目的通过对氨甲喋呤（MTX）治疗儿童急性淋巴细胞白血病的血药浓度研究,探讨MTX血药浓度与毒副作用等方面的关系,以及血药浓度监测的临床意义。方法采用荧光偏振免疫法测定53例患儿血清中MTX的血药浓度,分析血药浓度与不良反应发生的关系。结果24 h MTX血药浓度〉40μmol/L者黏膜损害发生率为79.2%（19/24）,16-40μmol/L黏膜损害发生率为15.1%（8/53）,而24h MTX浓度〉40μmol/L者肝功能损害发生率为75.0%（18/24）,16-40μmol/L肝功能损害发生率为17.0%（9/53）,差异有显著性（P〈0.05）。其他常见的不良反应有胃肠道反应、发热、骨髓轻度抑制、局部皮疹等。结论监测MTX血药浓度,有利于提高其治疗的安全有效性。
Objective To investigate the relationship among plasma concentration, dosage, clinical efficiency and toxicity of methotrexate （MTX） used in the treatment of childhood acute lymphoblastic leukemia, and to evaluate its clinical significance. Methods MTX was measured by a flurorescence polarization immunoassay （FPIA） in plasma samples obtained from patients with childhood acute lymphoblastic leukemia （ALL）, who were treated with MTX at different doses, and the results were analyzed combined with clinical manifestations. Results When the 24 h MTX plasma concentration 〉 40 μmol/L, the mucosa damage and hepatic lesion incidence rates were 79.2% （19/24） and 75.0% （18/ 24） respectively;when the 24 h MTX plasma concentration was 16 -40 μmol/L, the incidence rates of mucosa damage and hepatic lesion were 15. 1% （8/53） and 17. 0 % （9/53） respectively. The commonadverse reactions observed included gastrointestinal reactions, fever, mild bone marrow depression, local rashes, and so on. Conclusion The study of MTX plasma concentration and adverse reactions of high-dose methotrexate chemotherapy for children with acute lymphoblastic leukemia provided references for the individualized chemotherapy.
出处
《广东药学院学报》
CAS
2009年第1期91-93,共3页
Academic Journal of Guangdong College of Pharmacy
基金
广东省自然科学基金(8151037001000001)
广东省医学科学技术研究基金(A2008559)
