四氢叶酸钙解救甲氨蝶呤不良反应观察

Observation of Calium Folinate Treating Toxicity with Methotrextte

目的探讨甲酰四氢叶酸钙(CF)解救大剂量甲氨蝶呤(HD-MTX)应用安全性。方法将12例急性淋巴细胞白血病(ALL)(49例次)HD-MTX治疗病例(HD-MTX:标危3.0g/m2,高危5.0g/m2)随机分为两组。A组(25例次)MTX滴注起第42小时应用CF解救[15mg(/m.2次),Q6h×6次];B组(24例次)第36小时应用CF解救[15mg(/m.2次),Q6h×7次]。分别对两组病例在白细胞计数下降、血小板计数下降、恶心呕吐反应、口腔粘膜损害以及血清丙氨酸转氨酶改变等进行观察。结果A、B两组口腔粘膜损害、白细胞计数下降、血小板计数下降、恶心呕吐反应以及血清丙氨酸转氨酶改变等差异均无显著意义(P>0.05)。结论在充分合理的水化基础上应用CF延迟解救HD-MTX的毒副作用临床应用是安全的。

Objective To discuss application security of cahum folinate（CF） treating high-dose methotrexate（HD-MTX）. Methods The 12 cases of acute lymphoblastic leukemia（ALL）,were randomly divided into two groups after HD-MTX scheme. In two cases respectively decreased leukocyte count,platelet count dropped,vomiting,oral mucosed injury and serum alanine aminotransferase changes were observed. Results In observed group A and B oral mucosa damage decreased leukocyte count,platelet count dropped,nausea,vomiting,as well as changes in serum alanine aminotransferase,there was no significant difference （P 〉 0.05）. Conclusion On the basis of a reasonable application of hydration, CF delayed rescue the HD-MTX toxicity is safe.