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本文在MTX/CF疗法的MTX血浓度监测中应用微生物(Mehta及简易)法与荧光法互相比较。5例恶性肿瘤病人在6小时内静滴:MTX 1g,停药6小时后用CF解救,每6小时一次,每次肌注9mg。在6小时(滴注毕)、24及48小时测定MTX血药浓度,结果表明两种微生物法测得的结果相一致,但荧光法所测得的数值则远较微生物法高,24及48小时点尤为明显。微生物法测得的MTX安全阈值符合文献所载。5例的48小时血药浓度均在安全阈浓度5×10~(-8)M之下,临床未见严重毒性反应,表明微生物法能反映血清MTX抑制二氢叶酸还原酶的实际有效浓度,更适合于MTX/CF法的血药浓度监测。简易法较Mehta法简便、稳定、值得推广。
In this paper, MTX blood concentration monitoring of MTX / CF therapy using micro-organisms (Mehta and simple) method and fluorescence compared with each other. Five patients with malignant tumor intravenous infusion within 6 hours: MTX 1g, 6 hours after stopping with CF rescue, once every 6 hours, each intramuscular 9mg. MTX plasma concentration was measured at 6 hours (infusion completion), 24 and 48 hours, and the results showed that the results obtained by the two microbial methods were consistent, but the values measured by the fluorescence method were far higher than those by the microorganisms, 24 and 48 Hour is particularly obvious. The MTX safety threshold measured by the microbiological method is in line with the literature. The 48-hour plasma concentrations of 5 patients were all below the safety threshold concentration of 5 × 10 -8 M, and no serious toxic reactions were observed in the 5 patients. The results indicated that the microbiological method could reflect the actual effective concentration of MTX inhibiting dihydrofolate reductase, More suitable for monitoring blood concentration of MTX / CF method. The simple method is easier and more stable than the Mehta method, which is worth promoting.