大剂量甲氨蝶呤治疗恶性肿瘤后延迟排泄与合并使用质子泵抑制剂的相关性研究

The correlation between delayed elimination of high dose methotrexate after treatment of malignant tumor when co-administered with proton pump inhibitors

目的:研究大剂量甲氨蝶呤(HD-MTX)化疗方案后延迟排泄影响因素及与合并使用质子泵抑制剂(PPIs)之间的相关性。方法:收集108名共190次运用HD-MTX化疗的患者病例资料,以及253例次MTX血药浓度监测结果,使用多元线性回归分析、单因素方差分析和t检验等统计学方法分析延迟排泄的影响因素及与合并使用PPIs之间的相关性。结果:HDMTX延迟排泄发生与年龄呈正相关,与体质量呈负相关,与MTX剂量呈正相关,与合并使用PPIs呈正相关,其中影响因素最大的是MTX剂量,其次是合并使用PPIs。结论:运用HD-MTX化疗方案时应高度重视与PPIs的联用,应加强临床观察,确保用药安全。

OBJECTIVE To study on the influence factors of delayed elimination of high dose methotrexate（HD-MTX）chemotherapy and the correlation with co-administration of proton pump inhibitor（PPIs）.METHODS Records of 108 patients receiving 195 cycles of HD-MTX chemotherapy and 235 cases of MTX blood concentration monitoring results were reviewed to determine effects of PPI administration and other influence factors on MTX elimination.Multivariate line regression method,ANOVA,and t test were used to analyze the possible interactions.RESULTS HD-MTX delayed elimination was positively correlated with age,MTX dose and PPIs combination,negatively correlated with body weight.The greatest influence factor was MTX dosage,followed by the co-administration of PPIs.CONCLUSION When using HD-MTX chemotherapy scheme,great importance should be attached to the co-administration of PPIs,to strengthen clinical observation and ensure the safety of drug use.