| 杨 琳,谢瑞祥,杨 瑜,等.大剂量MTX不同给药方式治疗淋巴瘤的血药浓度与毒副反应研究[J].安徽医药,2015,19(11):2183-2186. |
| 大剂量MTX不同给药方式治疗淋巴瘤的血药浓度与毒副反应研究 |
| A study on serum concentrations and toxicities of two regimens of high-dose MTX in patients with NHL |
| 投稿时间：2015-06-05 |
| DOI： |
| 中文关键词: 甲氨蝶呤 非霍奇金淋巴瘤 给药方式 血药浓度 毒副反应 |
| 英文关键词: MTX NHL regimens serum concentration toxicity |
| 基金项目:国家临床重点专科建设项目、福建省卫生厅青年课题(No 2013-1-8) |
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| 中文摘要: |
| 目的 比较大剂量甲氨蝶呤(HD-MTX)治疗非霍奇金淋巴瘤(NHL)不同给药方式(6 h和24 h持续静脉滴注)MTX血药浓度和毒副反应的区别,并探讨MTX滴注结束后24 h、48 h发生延迟排泄与临床毒副反应的相关性。 方法 筛选得到该院HD-MTX单药化疗NHL患者44 例,共124例次。分别记录6 h给药组和24 h给药组MTX滴注结束后0、12、18、24、48 h的血药浓度和毒副反应,用SPSS进行数据统计分析。结果 6 h给药组0、12 h平均血药浓度分别为(304.88±137.67)、(4.93±4.39)μmol·L-1,明显高于24 h给药组(80.14±51.93)、(3.88±2.27)μmol·L-1(P均<0.05)。6 h给药组发生白细胞、中性粒细胞下降,谷丙转氨酶、谷草转氨酶升高例次数均少于24 h组(P<0.05)。滴注结束后48h延迟排泄与非延迟排泄比较,6 h给药组发生血红蛋白下降例次数增加(P<0.05)；24 h给药组发生白细胞、中性粒细胞下降,谷丙转氨酶、谷草转氨酶升高例次数增加(P<0.05)。结论 6 h给药方式预防和治疗淋巴瘤中枢转移更有优势；延迟排泄会加重毒副反应,可从相关代谢酶单核苷酸基因多态性方面进一步探讨。 |
| 英文摘要: |
| Objective TTo compare the HD-MTX serum concentrations and adverse reactions of two regimens (6-hour and 24-hour continuous venous infusion) in NHL patients and explore the connecting between 24,8 h excretion delays and adverse reactions. Methods 44 NHL patients with MTX monotherapy(total 124 courses)were screened out. Record the serum concentrations of 0,2,18,4,48 h and the adverse reactions, Data were analyzed by SPSS. Results The average MTX serum concentrations of 0h and 12h in 6-hour group were significantly higher than 24-hour group (304.88±137.67)vs(80.14±51.93)μmol·L-1,(4.93±4.39) vs(3.88±2.27)μmol·L-1, both two P<0.05). The toxicities of WBC,NE,ALT,AST in 6-hour group were lower than 24-hour group(P<0.05). The toxicity of HB in 6-hour group and the toxicities of WBC,NE,ALT,AST in 24-hour group were higher when excretion delay occurred at 48 h after administration(P<0.05).Conclusion 6-hour infusion is more preferable to prevent and treat CNS replase. There are more toxicities when excretion delay occurred,it is worthy to further explore SNPs. |
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