摘要
目的测定患儿甲氨蝶呤(MTX)的血药浓度,并对大剂量MTX治疗儿童急性淋巴细胞白血病(ALL)血药浓度监测结果进行分析。方法 35例ALL患儿接受139例次大剂量MTX治疗。治疗的剂量为标危组17例采用MTX 2 g.m-2.次-1,中危组18例采用MTX 5 g.m-2.次-1。应用大剂量MTX治疗后42 h用亚甲酰四氢叶酸钙(CF)解救。并在48、72 h用荧光偏振免疫分析(FPIA)法监测MTX的血药浓度。结果 139例次48 h的MTX血药浓度为(0.6±s 1.0)μmol.L-1、79例次72 h的MTX血药浓度为(0.2±0.4)μmol.L-1。标危组与中危组48 h MTX浓度有显著差异(P=0.036),72 h MTX浓度无差异(P>0.05)。结论不同危险度分组之间,不同个体之间,MTX血药浓度差异大,监测MTX血药浓度有重要的临床意义,可以作为调整CF用量的主要依据。
AIM To determine the plasma drug concentration of methotrexate（MTX）by FPIA and analyze the result of blood concentration monitoring of acute lymphoblastic leukemia（ALL）treated with high-dose methotrexate（HD-MTX）.METHODS Thirty-five hospitalized children with ALL received a total of one-hundred and thirty-nine courses with HD-MTX.The dosage was 2 g·m-2 for 17 children,and 5 g·m-2 for 18 children.To rescue with calicium folinate at 42 h after treated with HD-MTX.Blood concentration of MTX was monitored by FPIA at 48 and 72 h after the treatment in each course.RESULTS Blood concentration of MTX at 48 and 72 h after the administration were（0.6 ± s 1.0）and（0.2 ± 0.4）μmol·L-1,respectively.There was significant difference in blood concentration of MTX between two groups at 48 h（P = 0.036）.There was no significant difference at 72 h（P 0.05）.CONCLUSION There is large individual variation in the disposition of MTX.The blood concentration of MTX could be the reference for the use of calicium folinate.
出处
《中国新药与临床杂志》
CAS
CSCD
北大核心
2010年第11期850-852,共3页
Chinese Journal of New Drugs and Clinical Remedies
关键词
甲氨蝶呤
淋巴细胞白血病
儿童
血药浓度
methotrexate leukemia lymphoid child plasma drug concentration
