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目的通过对急性淋巴细胞白血病患儿采用甲氨喋呤结合亚叶酸钙(HD-MTX-CF)化疗方案中血药浓度结果的分析,探讨甲氨蝶呤(MTX)血药浓度监测的临床意义,同时考察MTX排泄的个体差异性。方法采用HPLC法监测接受HD-MTX化疗的49例急性淋巴细胞白血病患儿的血药浓度,并应用SPSS13.0软件分析监测结果。结果自HD-MTX开始给药后48、72h,MTX血药浓度的变异系数较大;72h与48h血药浓度对数值呈正相关;MTX血药浓度监测提示:49例患儿的预期抗白血病作用较好,但MTX排泄延迟的现象发生次数较多。结论MTX的末端消除过程存在极大的个体差异性,HD-MTX-CF化疗过程需要在血药浓度监测下实施。给药后48h点的血药浓度对于后期排泄情况有一定的预见性,值得重视。
Objective To investigate the clinical significance of blood concentration monitoring of methotrexate (MTX) in children with acute lymphoblastic leukemia by analyzing the results of plasma concentration of methotrexate and leucovorin (HD-MTX-CF) chemotherapy regimen , While examining the individual differences in MTX excretion. Methods The plasma concentration of 49 children with acute lymphoblastic leukemia receiving HD-MTX chemotherapy was monitored by HPLC. The monitoring results were analyzed by SPSS 13.0 software. Results The coefficient of variation (MTX) of MTX plasma concentration was relatively high at 48 and 72h after the start of HD-MTX treatment. The plasma concentration of 72h and 48h showed a positive correlation with the values. The MTX plasma concentration monitoring indicated that 49 patients were expected to have anti-leukemia effect Better, but MTX excretion is delayed more often. Conclusion There is a great individual difference in the end-stage elimination of MTX. The HD-MTX-CF chemotherapy needs to be implemented under the monitoring of plasma concentration. 48h after administration of plasma concentration for the latter part of the excretion have some predictability, it is worth attention.