不同剂量甲氨蝶呤治疗儿童白血病的效果及用药安全性分析

Analysis on Effect and Medication Safety of Different Doses of Methotrexate in the Treatment of Children with Leukemia

目的探讨不同剂量甲氨蝶呤治疗儿童白血病的效果及用药安全性。方法将80例白血病患儿随机分为两组各40例,对照组给予3.0 g/m2甲氨蝶呤治疗,观察组给予5.0 g/m2甲氨蝶呤治疗,比较两组的临床疗效、不良反应及不同时刻的血药浓度。结果观察组治疗有效率为87.5%,高于对照组的67.5%(P<0.05)。观察组不良反应发生率为57.5%,与对照组的50.0%比较差异无统计学意义(P>0.05)。观察组治疗24 h时的血药浓度高于对照组(P<0.05);两组患者治疗48 h、72 h时的血药浓度比较差异无统计学意义(P>0.05)。结论与低剂量甲氨蝶呤相比,高剂量甲氨蝶呤治疗儿童白血病的临床效果显著,且不会明显增加不良反应,但治疗过程中应密切监测血药浓度,调整后续用药剂量。

Objective To explore the effect and medication safety of different doses of methotrexate in the treatment of children with leukemia.Methods 80 children with leukemia were randomly divided into two groups,with 40 cases in each group.The control group was treated with 3.0 g/m2 methotrexate,and the observation group was treated with 5.0 g/m2 methotrexate.The clinical efficacy,adverse reactions and blood drug concentrations at different time were compared between the two groups.Results The effective rate of the observation group was 87.5%,higher than 67.5%of the control group(P<0.05).The incidence of adverse reactions in the observation group was 57.5%,which had no statistical difference with 50.0%in the control group(P>0.05).24 h after treatment,the blood drug concentration of the observation group was higher than that of the control group(P<0.05).No statistical difference was found in the blood drug concentration at 48 h and 72 h after treatment between the two groups(P>0.05).Conclusions Compared with low-dose methotrexate,high-dose methotrexate has significant clinical effect in the treatment of children with leukemia,and does not significantly increase the adverse reactions,but the blood drug concentration should be closely monitored during treatment and the subsequent drug dose should be adjusted.