摘要
目的分析大剂量甲氨蝶呤(HD-MTX)(抗代谢性抗肿瘤药)治疗原发性中枢神经系统淋巴瘤(PCNSL)的血药浓度特点,并对其血药浓度进行监测。方法对本院收治的19例PCNSL患者,进行50例次HD-MTX化疗,并监测化疗后不同时间点MTX血药浓度,综合分析血药浓度特点及其与患者性别、年龄及MTX剂量的相关性,并分析不良反应的发生和处理。结果 MTX化疗后,利用亚叶酸钙(CF)解毒后,大部分患者MTX血药浓度能在66 h降至安全浓度(0.05μmol.L-1以下)。MTX消除与患者年龄及其剂量有相关性,与性别无关。在使用CF解救及血药浓度监测和充分水化、碱化的情况下,HD-MTX方案未发生严重不良反应。结论化疗后,监测MTX血药浓度并适时、适量给予CF解救,是保证HD-MTX临床用药安全的关键因素。
Objective To study plasma concentration and adverse drugs reaction（ADR） of high-dose methotrexate（HD-MTX） administered in patients with primary central nervous system lymphoma（PCNSL） and to improve the efficacy and safety of HD-MTX administration.Methods A total 50 cases of HD-MTX were administered to 19 patients with PCNSL in our hospital,and these cases were collected from 2009/01 to 2010/07.The plasma samples were collected and the plasma concentrations of MTX were detected at different times.The covariates factors including sex,age and doses of MTX were analysised.The ADR of HD-MTX was detected and resolved.Results Most MTX concentration of plasma reduced to the safe range of 0.05 μmol·L-1 after 66 hours.MTX levels of plasma were remarkably related to patient age and doses of MTX,but sex did not impact on the levels.Serious ADR were not found after calcium folinate（CF） rescue,monitor plasma concentration of MTX,adequate hydration and alkalization.Conclusion Monitor plasma concentration of MTX,adequate hydration and alkalization,administered CF play an important role in HD-MTX.
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2011年第3期218-222,共5页
The Chinese Journal of Clinical Pharmacology
关键词
原发性中枢神经系统淋巴瘤
甲氨蝶呤
血药浓度
药物不良反应
primary central nervous system lymphoma
methotrexate
plasma concentration
adverse drugs reaction
