摘要
目的:探讨急性淋巴系恶性肿瘤患儿的大剂量甲氨蝶呤(HDMTX)持续静滴时间及四氢叶酸钙(LCV)解救的开始时间。方法:27例患儿共接受三种HDMTX方案治疗99例次,1g/m2静滴36h、3g/m2静滴24h和5g/m2静滴24h分别为14、58和27例次。荧光偏振免疫法(FPIA)测定MTX血浓度,NONMEM软件进行模型拟合和群体药动学参数的计算,计算不同时间的MTX浓度。结果:HDMTX静滴为二室模型分布,三种HDMTX方案的MTX血药浓度达到稳态的时间为8￣11h。MTX由分布相转入消除相的时间为MTX静滴结束后的12h左右(10￣17.4h)。结论:HDMTX的持续静滴时间不应少于8￣11h,LCV开始解救的中位时间为MTX静滴结束后的12h,最晚不应超过MTX静滴结束后的17.5h。
Objective： To investigate the infusion duration of high-dose methotrexate and the start time of leucovorin rescue in children＇s acute lymphocytic malignant tumor. Methods： A total of 99 courses of HDMTX were administered to 27 patients. The numbers of patients who were given 1 g/m^2 of MTX over 36 hours, and 3 g/m^2- amd 5 g/m^2 of MTX over 24 hours was 14, 58 and 27 respectively. Fluorescence polarization immunoassay （FPIA） was used to determine MTX plasm concentrations. Population pharmacokinetic model and parameters were estimated by NONMEM software. MTX concentrations during and after MTX infuson were simulated. Results： The population parameters were estimated with a two-compartment model. The time to reach steady state plasm concentration was 8 -11 houres after MTX infusion. The elimination phase started in 12 hours （10 - 17.4 hours） after the end of MTX infusion. Conclusions： The duration of HDMTX infusion should not be less than 8 -11 hours. The leucovorin rescue should start in 12 hours and no later than 17.5 hours affter the end of MTX infusion.
出处
《儿科药学杂志》
CAS
2006年第1期1-4,共4页
Journal of Pediatric Pharmacy
