【摘要】 为了监测大剂量甲氨喋呤（ＨＤＭＴＸ）化疗时脑脊液中药物浓度的动态变化，采用高效液相色谱法对１２例患者２０例次静脉点滴ＨＤＭＴＸ（每次１．５～３．０ｇ）后的脑脊液和血浆中ＭＴＸ浓度同时进行监测，并以２例常规ＭＴＸ用量（每次６０ｍｇ）的脑脊液监测浓度做对比。结果显示，滴注ＭＴＸ后０，６，１２，２４，３６ｈ的脑脊液ＭＴＸ平均浓度分别为３．３７×１０－６，６．８３×１０－７，１．６８×１０－７，２．９９×１０－８，０．４０×１０－８ｍｏｌ／Ｌ，血浆ＭＴＸ平均浓度分别为８．７０×１０－５，２．７９×１０－５，２．６７×１０－６，７．０７×１０－７，６．６５×１０－８ｍｏｌ／Ｌ。２例常规ＭＴＸ用量者的脑脊液ＭＴＸ浓度未测出。结果表明ＨＤＭＴＸ化疗时，脑脊液ＭＴＸ浓度是血浆ＭＴＸ浓度的（４．５７±１．６０）％，２者呈线性关系。并提示ＭＴＸ透过血脑屏障的机理可能为被动转运。更多还原

【Abstract】 In order to investigate the dunamic change of MTX concentration in cerebrospinal fluid after high dose methotrexate(HDMTX) was administered,the MTX concentrations in cerebrospinal fluid and plasma were measured by High Performance Liquid Chromatography(HPLC) in 12 patients(20 cases) administered with HDMTX(1.53.0) and in 2 patients with low dose MTX(60 mg).The results showed that the average cerebrospinal fluid MTX concentration was 3.3710-6(0 h),6.8310-7(6 h),1.6810-7(12 h),2.9910-8(24 h) and 0.4010-8 mol/L(36 h),respectively,while the average plasma concentration of MTX was 8.7010-5(0 h),2.7910-5(6 h),2.6710-6(12 h),7.0710-7(24 h) and 6.6510-8 mol/L(36 h) when HDMTX was administered.The MTX concentration of cerebrospinal fluid was(4.571.60)% of the plasmas and there was a linear correlation to each other.The MTX concentration of cerebrospinal fluid couldnt be detected in 2 patiets treated with low dose MTX.The mechanism that MTX passed bloodcerebral barrier may be passive transference.更多还原