【摘要】 目的 :探讨甲氨蝶呤 (MTX)用于小儿急性淋巴细胞白血病 (ALL)化疗时 ,剂量增至 4g·m-2 是否更为有效且安全。方法 :对 2个剂量组 (3g·m-2 ,4g·m-2 )各 15例次进行MTX血药浓度及不良反应发生率的比较。血药浓度测定方法采用荧光偏振免疫法 (FPIA)。结果 :4g·m-2 剂量组静滴结束时 (12h)血药浓度显著高于 3g·m-2 剂量组 (P <0 0 5 ) ,不同个体间血药浓度及脑脊液浓度水平差异较大 ,2剂量组的不良反应发生率无明显差异 (P >0 0 5 )。结论 :在进行MTX血药浓度监测的情况下 ,要掌握好救援时间和剂量 ,采用 4g·m-2 的剂量能够耐受更多还原

【Abstract】 AIM: To investigate if the dosage of methotrexate (MTX) can be increased to 4 g·m -2 with better effect and security in chemotherapy of children with acute lymphocyte leukemia (ALL). METHODS: Compared the serum concentration of MTX and the adverse drug reaction incidence between 2 groups of high-dose MTX (3 g·m -2, 4 g·m -2) with each 15 cases. The concentration was monitored by using the method of fluorescence polarization immunoassay (FPIA). RESULTS: At the time of MTX infusion completed (12 h), the serum concentration of MTX of the 4 g·m -2 group was remarkably higher than that of the 3 g·m -2 (P<0.05). The concentration in serum and cerebrospinal fluid had great imparity among individuals. There was no difference in the adverse drug reaction incidence between the 2 groups (P>0.05). CONCLUSION: The MTX dosage of 4 g·m -2 can be tolerated with the serum concentration of MTX monitored and in control of rescuing time and dosage rationally.更多还原