摘要
目的:观察大剂量甲氨蝶呤加四氢叶酸钙(HDMTX+CF)治疗儿童急性淋巴细胞白血病(ALL)出现的甲氨蝶呤(MTX)排泄延迟,与患儿性别、民族及MTX给药剂量的关系,探讨如何预防和减少排泄延迟的发生。方法:分析67例儿童ALL进行的226次HDMTX+CF化疗的MTX血清药物浓度测定数据,分别按患儿性别、民族及MTX剂量分组,比较各组MTX排泄延迟的发生率。结果:患儿总的排泄延迟发生率为27.0%;男性组排泄延迟发生率为29.3%,女性组排泄延迟发生率为22.8%;汉族组排泄延迟发生率为22.9%,少数民族组排泄延迟发生率为33.7%;3g.m-2MTX组的排泄延迟发生率为20.0%,5g.m-2MTX组的排泄延迟发生率为30.6%。各组的排泄延迟发生率经比较差异均无统计学意义(P>0.05)。结论:HDMTX+CF化疗出现MTX排泄延迟与患儿性别、民族及MTX剂量之间的差异无关,而与患儿的个体差异及MTX在体内的药动学特点有关。
OBJECTIVE： To evaluate the correlation between the elimination delay of high- dose methotrexate （HDMTX） chemotherapy and childrens＇ genders, nationalities and the MTX dosages in the treatment of children with acute lymphoblastic leukemia （ALL）, and to explore the way to prevent and avoid the occurrence of the elimination delay. METHODS： The serum concentrations of MTX in 67 children with ALL who had undergone 226 times of chemotherapy （HDMTX ＋ CF） in total were determined, and then the patients were divided into different groups based on patients＇ genders, nationalities and MTX dosages with the incidences of the elimination delay of MTX compared among groups. RESULTS： The overall incidence of the elimination delay of MTX was 27.0% ; the incidence of the elimination delay was 29.3% in male group vs. 22.8% in female group; 22.9% in the Han nationality group vs. 33.7% in minority ethnic group; 20.0% in the 3 g ·m^-2 MTX group vs. 30.6% in the 5 g ·m^-2 MTX group. There were no significant differences in elimination delay rate among groups （P 〉0.05）. CONCLUSION： Elimination delay of MTX presented in children treated with high dose methotrexate （HDMTX） chemotherapy is independent of childrens＇ genders, nationalities and the dosages of MTX, but associated with the individual differences and the pharmacokinetic characteristics of MTX in children.
出处
《中国药房》
CAS
CSCD
北大核心
2009年第29期2265-2268,共4页
China Pharmacy
基金
广西壮族自治区卫生厅自筹经费科研课题(Z2007091)
关键词
甲氨蝶呤
儿童急性淋巴细胞白血病
排泄延迟
Methotrexate
Children with acute lymphoblastic leukemia
Elimination delay
