【摘要】 目的:探讨大剂量甲氨蝶呤化疗方案治疗儿童急性淋巴细胞白血病导致血药浓度异常升高的影响因素,为临床合理使用提供帮助。方法:通过医院电子病历系统,查阅患者各项诊疗、检查及用药资料,根据相关指南和诊疗规范对1例大剂量甲氨蝶呤治疗儿童急性淋巴细胞白血病血药浓度异常升高的用药情况进行分析。结果:该患者甲氨蝶呤血药浓度超过正常值10天,可能与化疗方案的选择、亚叶酸钙的解救、水化碱化、合并用药等因素相关。结论:临床医生应关注影响甲氨蝶呤血药浓度的多种因素,提高疗效,减少不良反应的发生;临床药师有必要参与患者治疗。更多还原

【Abstract】 Objective:To explore the influencing factors for abnormally high blood concentration in high-dose methotrexate chemotherapy for children with acute lymphoblastic leukemia to provide help for clinical rational drug use.Methods:Through the hospital electronic medical records system,the diagnosis,treatment,examinations and medication information of one child with acute lymphoblastic leukemia treated with high-dose methotrexate and complicated with abnormally high blood concentration were reviewed,and according to the relevant guidelines and diagnosis norms,the medication of the patient was analyzed.Results:The patient’s methotrexate plasma concentration exceeded the normal value for more than 10 days,which was related with the choice of chemotherapy,leucovorin rescue,hydration and alkalization,drug combination and so on.Conclusion:Clinicians should pay attention to the influencing factors for methotrexate blood concentration in order to enhance the effectiveness and reduce the incidence of adverse reactions,and clinical pharmacists should participate in the treatment of the patients.更多还原