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目的:根据使用大剂量甲氨蝶呤进行化疗的骨肉瘤患者24 h血药浓度值(C24h),对有可能发生延迟排泄的患者进行提前预警,与临床协作对患者后续的治疗方案及时进行调整,并且为今后制定更加合理的MTX解救流程提供数据支持。方法:对某院2010年8月至2015年8月进行甲氨蝶呤血药浓度监测的骨肉瘤患者的C24h数据共3 515例进行分析,并研究C24h与延迟排泄的关系。结果:C24h具有一定规律性,与甲氨蝶呤血药浓度达标所需时间成正相关。建立C24h危急值报告制度对调整后续治疗方案及患者用药安全预警具有一定实际意义。结论:应通过监测C24h及时调整后续治疗方案,并对高血药浓度患者尽早处理,防止对患者造成严重损伤。
OBJECTIVE: To evaluate the 24 h serum concentration (C24h) of patients with osteosarcoma who received high dose methotrexate chemotherapy for early warning of patients who may have delayed excretion, and to make timely adjustments to the follow-up treatment plans of patients with clinical cooperation , And provide data support for making a more reasonable MTX rescue process in the future. Methods: A total of 3 515 patients with osteosarcoma who underwent methotrexate plasma concentration monitoring from August 2010 to August 2015 in a hospital were analyzed, and the relationship between C24h and delayed excretion was studied. Results: C24h had a certain regularity, which was positively correlated with the time required for reaching methotrexate plasma concentration. The establishment of C24h critical value reporting system has some practical significance for adjusting follow-up treatment programs and early warning of medication safety for patients. Conclusion: Follow - up C24h should be used to adjust the follow - up treatment in time, and patients with high plasma concentration should be treated as soon as possible to prevent serious injury to patients.