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目的:通过对大剂量甲氨蝶呤治疗儿童急性淋巴细胞白血病不同时间点血药浓度监测结果的统计,分析不同患儿体内甲氨蝶呤的消除情况,并探讨其末端消除对血药浓度的影响,为临床制定个体化给药方案提供依据。方法:对2006年1月-2007年8月使用大剂量甲氨蝶呤治疗并在我院进行监测的急性淋巴细胞白血病患儿144例共461例次的血药浓度结果进行回顾性统计,并对不同患儿体内甲氨蝶呤的消除情况加以分析。结果:不同患儿体内甲氨蝶呤的消除情况特别是末端消除表现出很大的个体差异,需根据临床实际情况进行监测和解救。结论:甲氨蝶呤血药浓度监测能较好地指导临床对急性淋巴细胞白血病患儿特别是伴有末端延迟消除的患儿进行解救,保证了用药的安全性。
OBJECTIVE: To analyze the elimination of methotrexate in children with different doses of methotrexate for the treatment of children with acute lymphoblastic leukemia at different time points, and to explore the relationship between elimination of end-stage methotrexate and Influence, provide the basis for the clinical development of individualized drug delivery program. Methods: A total of 461 cases of plasma concentrations of 144 children with acute lymphoblastic leukemia treated with high-dose methotrexate and monitored in our hospital from January 2006 to August 2007 were retrospectively analyzed. Methotrexate in different children to eliminate the situation to be analyzed. Results: The elimination of methotrexate in different children, especially the elimination of the end showed a great individual differences, according to the actual situation to be monitored and rescued. Conclusion: Methotrexate blood concentration monitoring can better guide the clinical treatment of children with acute lymphoblastic leukemia, especially with the termination of delayed elimination of children to rescue, to ensure the safety of medication.