我院34例注射用甲氨蝶呤不良反应报告的回顾性分析

Retrospective Analysis of 34 Cases of Adverse Reactions Induced by Methotrexate

目的：了解注射用甲氨蝶呤不良反应的临床特点，以期为临床安全合理用药提供参考。方法收集2005～2012年我院34例注射用甲氨蝶呤不良反应报告，采用回顾性研究的方法，对其年龄、性别、用药情况、不良反应的类型以及主要临床表现等进行统计与分析。结果34例患者中男24例（70.59%），女10例（29.41%）。年龄8～33岁，其中11～15岁共15例（44.12%）。注射用甲氨蝶呤所致不良反应从用药后10分钟到7日后皆可发生。不良反应累及多个系统-器官，临床表现复杂多样。其中以皮肤及其附件损害最多，其次是消化系统损害、全身性损害、神经系统损害、黏膜损害和生殖系统损害等。结论注射用甲氨蝶呤在大剂量使用时应引起临床高度重视，加强不良反应监测，早期发现给予对症治疗，保障患者用药安全。

Objective To investigate the clinical features of the adverse reactions caused by methotrexate, provide reference for rational use of methotrexate. Methods 34 cases of methotrexate adverse reaction reports in Beijing Jishuitan hospital were retrospectively analyzed on the age, sex, administration and dosage, the type of adverse reactions, the main clinical manifestations from 2005 to 2012. Results 24 patients （70.59%） were male in 34 cases and 10 were female （29.41%）. Age range was 8 to 33 years old, 15 cases were 11 to 15 years old （44.12%）. The adverse reactions induced by methotrexate could occur in ten minutes after administration, could also occur in seven days. Adverse reactions involved multiple systems, and the clinical manifestations were complicated and diversified. Damage to the skin and its appendages was the hightest, followed by the digestive system, systemic damage, nervous system, mucosal damage and reproductive system. Conclusion The analysis concludes that adverse events of high-dosage methotrexate deserve more clinical attention, strengthening the monitoring of adverse reactions, early detecting of symptomatic treatment and protecting patients medication safely.