【摘要】 作者研究大剂量顺铂（ＤＤＰ）、甲氨喋呤（ＭＴＸ）化疗的肾毒性及监测方法。对２１例骨及软组织恶性肿瘤患者手术前、后给予大剂量ＤＤＰ或ＭＴＸ化疗４４次。化疗前及化疗后９６ｈ分别测定血清尿素氮（Ｕｒｅａ）、血清肌酐（Ｃｒ）、血和尿中β２－微球蛋白（β２－Ｍ）的含量。２０例ＤＤＰ化疗后１４例尿β２－Ｍ有不同程度升高（Ｐ＜０．０５）。２４次ＭＴＸ化疗后肾功能监测值较化疗前无统计学意义。根据尿β２－Ｍ监测大剂量ＤＤＰ及ＭＴＸ化疗肾小管损害程度，结果灵敏可靠，对尿β２－Ｍ超过０．２５μｇ／ｍｌ的患者应停止大剂量ＤＤＰ或ＭＴＸ化疗。更多还原

【Abstract】 The renal toxicity of high dose cisplatin and methotrexate in chemotherapy of bone and soft tissue malignancies as well as means of surveillance were studied. Twenty one patients with bone and soft tissue malignancies were treated with high dose DDP or MTX chemotherapy. The levels of serum urea, creatinin , blood and urine β 2 microglobulin (β 2 M) were measured prior to and after administration of these agents. Following DDP infusion, the urine β 2 M in 14/20 cases was elevated ( P <0.05).The renal function changes after MTX chemotherapy were devoid of statistical significance.This study imlicated DDP in leading to nephrotoxicity more frequently than MTX; and that urine β 2 M serves as a sensitive indicator of reabsorption ability of renal tubules especially when β 2 M level exceeds 0.25μg/ml . It seems that high dose DDP or MTX should be withheld when urine β 2 M exceeds 0.25μg/ml.更多还原