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目的：本文对不同时间静滴大剂量氨甲蝶呤／醛氢叶酸解救治疗血液肿瘤患者的血药浓度进行监测及药效和毒性反应进行研究。方法：采用高效液相色谱法测定氨甲蝶呤的血药浓度，按不同时间静滴大剂量氨甲蝶呤将４１例病人分为两组；Ｓ组氨甲蝶呤于６ｈ滴完，Ｌ组于１２ｈ滴完，两组均在滴注完６ｈ开始醛氢叶酸救援。在滴注毕０．８、６、４２ｈ采血测定氨甲蝶呤血药浓度。结果：Ｓ组药物浓度在０．０８ｈ显著高于Ｌ组（Ｐ＜０．０１），６、１８、４２ｈ两组血药浓度无差异（Ｐ＞０．０１）。完全缓解率中位持续完全缓解及中位生存期两组间无显著差异（Ｐ＞０．０５），Ｌ组毒性反应明显比Ｓ组严重。结论：６ｈ滴完组的疗效比１２ｈ滴完组的好。
OBJECTIVE: To study the effects of methotrexate / methotrexate on patients with hematological malignancies treated with intravenous infusion of high dose of methotrexate / Methods: The plasma concentration of methotrexate was determined by HPLC. 41 patients were divided into two groups according to the different doses of methotrexate intravenously. End of the group drip finished 12h, two groups were started after the infusion of 6h infusion of aldehyde folate rescue. At the end of drip completed 0.8,6,42h determination of methotrexate plasma concentration. Results: The drug concentration in group S was significantly higher than that in group L at 0.08 h (P <0.01). There was no difference between the two groups at 6, 18 and 42 h (P> 0.01). There was no significant difference between the two groups in the median complete remission rate and median survival (P> 0.05). The toxicity of L group was significantly higher than that in S group. Conclusion: The efficacy of 6h drop group is better than that of 12h drop group.