大剂量甲氨蝶呤治疗儿童急性淋巴细胞白血病体内消除情况的分析

Analysis of elimination in high dose methotrexate therapy in children acute lymphoblastic leukemia

目的:通过对大剂量甲氨蝶呤治疗儿童急性淋巴细胞白血病不同时间点血药浓度监测结果的统计,分析不同患儿体内甲氨蝶呤的消除情况,并探讨其末端消除对血药浓度的影响,为临床制定个体化给药方案提供依据。方法:对2006年1月-2007年8月使用大剂量甲氨蝶呤治疗并在我院进行监测的急性淋巴细胞白血病患儿144例共461例次的血药浓度结果进行回顾性统计,并对不同患儿体内甲氨蝶呤的消除情况加以分析。结果:不同患儿体内甲氨蝶呤的消除情况特别是末端消除表现出很大的个体差异,需根据临床实际情况进行监测和解救。结论:甲氨蝶呤血药浓度监测能较好地指导临床对急性淋巴细胞白血病患儿特别是伴有末端延迟消除的患儿进行解救,保证了用药的安全性。

OBJECTIVE According to statistics monitoring results of high dose methotrexate therapy in children acute lymphoblastic leukemia at different time points to analyze the elimination of methotrexate in different children, and discuss the influence of terminal elimination to the serum concentration, and give clinical reference to determine individual remedy. METHODS Methotrexate serumconcentration of 144 patients with acute lymphoblastic leukemia using high dose methotrexate therapy in our hospital during 2006. 1-2007. 8 was monitored, and analyed the elimination of methotrexate in different children patients. RESULTSThe eliminationof methotrexate in different children had great imparity, especially the terminal elimination phase.CONCLUSION The monitoring of methotrexate serum concentration can guide clinic to rescue children acute lymphoblastic leukemia especially for those having terminal elimination phase,and ensure the safety of medication.