大剂量甲氨蝶呤血药浓度影响因素和检测方法的研究进展

Research progress in influential factors and determination methods of plasma concentration of high-dose methotrexate

甲氨蝶呤(methotrexate,MTX)是一种抗代谢的细胞毒药物,大剂量甲氨蝶呤(high-dose methotrexate,HD-MTX)辅以亚叶酸钙解救疗法是临床上治疗急性淋巴细胞白血病、骨肉瘤、恶性淋巴瘤等多种癌症的治疗方案。但是大剂量甲氨蝶呤给药时的毒性较大,且人体内代谢个体差异显著。若发生排泄延迟则有可能出现严重的不良反应。本文对大剂量甲氨蝶呤的药动学、血药浓度的影响因素和血药浓度检测方法进行综述,为临床医师和药师提供参考,使患者得到更加安全、合理的药物治疗。

Methotrexate (MTX) is an anti-metabolic cytotoxic drug.High-dose methotrexate (HD-MTX) supplemented with calcium leucovorin is a profile for clinical treatment of acute lymphoblastic leukemia,osteosarcoma,malignant lymphoma and other cancers.However,HD-MTX may produce serious toxicity and significant differences may exist individually.Serious adverse drug reactions may occur,should there be delayed metabolic excretion.This paper is a comprehensive review on the pharmacokinetics,influential factors and detection methods of plasma concentration of HD-MTX,and will provide reference for clinicians and pharmacists and safe and rational use of HD-MTX will be ensured clinically.