【摘要】 目的　比较大、中剂量甲氨喋呤疗法预防髓外白血病的副作用。②方法　 10 6例急性淋巴细胞白血病病儿中有 4 6例 (180例次 )接受中剂量甲氨喋呤疗法 ,6 0例 (35 0例次 )接受大剂量疗法 ,观察两组副作用发生情况。③结果　两组均有明显的消化道反应 ,中剂量组消化道黏膜炎发生率明显高于大剂量组 (χ2 =2 6 .71,P <0 .0 0 1)。两组均可出现罕见的中枢神经毒性。大剂量组少数病儿出现一过性肝脏、心脏毒性反应 ,极少数短期内骨髓复发。④结论　大剂量甲氨碟呤预防髓外白血病方法可靠、安全。但应高度重视其副作用 ,不宜作为骨髓的加强治疗药物更多还原

【Abstract】 Objective\ To compare the side effects between medium dose and high dose methotrexate in prophylaxis of extramedullary leukemia. \ Methods\ 106 children with acute lymphocytic leukemia were treated, in which, 46 cases(180 case time) received medium dose and 60 cases(350 case time) received high dose of methotrexate, respectively. The side effects of both groups were studied.\ Results\ There was significant gastrointestinal toxic reaction in both groups, but the incidence of inflammatory manifestations in medium dose group was significantly higher than that of the high dose group( χ 2=26.71, P <0.001). A transient toxic reaction was noted in liver and heart in a few high dose cases. Rare toxic reaction of central nervous system was also seen in both groups. A few cases recurred in a short duration after the treatment. \ Conclusion\ High dose methotrexate therapy is safe and reliable for prophylaxis of extramedullary leukemia ,but great attention should be paid to its side effects and it shouldnt be used in intensive therapy.更多还原