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目的探讨大剂量甲氨蝶呤(MTX)治疗儿童急性淋巴细胞白血病血药浓度与不良反应相关性,为临床合理用药提供依据。方法采用荧光偏振免疫法测定72位患儿血药浓度,结合临床不良反应观察,采用χ2检验分析血药浓度与不良反应发生的关系。结果血清MTX C24 h≥40μmol.L-1的常见不良反应发生率与血清MTX C24 h<40μmol.L-1相比有显著性差异(P<0.05)。血清MTX C48 h≥1.0μmol.L-1的不良反应发生率与血清MTX C48 h<1.0μmol.L-1相比有极显著性差异(P<0.01)。结论 MTX不良反应的发生率直接取决于MTX血药浓度的高低和持续时间的长短。
Objective To investigate the relationship between the high dose methotrexate (MTX) treatment of children with acute lymphoblastic leukemia and adverse reactions, and to provide a basis for clinical rational drug use. Methods Fluorescence polarization immunoassay was used to determine plasma concentration in 72 children. Combined with clinical adverse reactions, the relationship between plasma concentration and adverse reactions was analyzed by χ2 test. Results The incidence of common adverse reactions of serum MTX C24h≥40μmol.L-1 was significantly lower than that of serum MTX C24h <40μmol.L-1 (P <0.05). The incidence of adverse reactions in serum MTX C48h≥1.0μmol.L-1 was significantly different from that in serum MTX C48h <1.0μmol.L-1 (P <0.01). Conclusion The incidence of MTX adverse reactions directly depends on the level of MTX plasma concentration and the duration of the duration.