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目的观察大剂量甲氨蝶呤(MTX)化疗在骨肉瘤治疗中血药浓度监测的意义。方法30例骨肉瘤患者接受30例次大剂量MTX化疗,每次6～10g/m2,应用后6h用亚叶酸钙(CF)解救。监测用药后MTX的血药浓度。结果用药后0、24、48、72hMTX的血药浓度分别为(388.84±101.06)μmol/L、(7.00±7.18)μmol/L、(0.98±1.17)μmol/L、(0.31±0.37)μmol/L。结论MTX在体内处置个体差异大,监测血清MTX浓度,充分水化、碱化,适时CF解救,是保证大剂量使用MTX临床安全的关键因素。
Objective To observe the significance of high dose methotrexate (MTX) chemotherapy in the monitoring of blood concentration in the treatment of osteosarcoma. Methods Thirty patients with osteosarcoma received 30 sub-maximal doses of MTX chemotherapy, 6-10 g / m2 each time, and were rescued with leucovorin (CF) 6 hours after application. Monitor the plasma concentration of MTX after treatment. Results The plasma concentrations of MTT at 0, 24, 48 and 72 h after drug administration were (388.84 ± 101.06) μmol / L, (7.00 ± 7.18) μmol / L, 0.98 ± 1.17 μmol / L and 0.31 ± 0.37 μmol / L. Conclusion MTX treatment of individual differences in vivo, monitoring of serum MTX concentration, full hydration, alkalization, timely CF rescue, is to ensure high-dose MTX clinical safety key factors.