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目的 对骨及软组织肿瘤患者采用大剂量甲氨蝶呤 (MTX)化疗过程中的血药浓度进行动态监测 ,以保证MTX血药浓度在整个化疗过程中处于合适的治疗浓度。并对停止化疗后高浓度的MTX在体内的消除规律进行研究 ,为临床减少MTX毒副反应提供依据。方法 采用HPLC测定血清中MTX浓度 ,并以测定结果为依据调整滴注速度。对化疗结束后 0～ 2 4h的血药浓度 时间数据用 3P87药动学程序进行模型拟合计算药动学参数。结果 HPLC测定血清MTX浓度快速 ,准确 ,可及时调整给药速度 ,大多数患者化疗过程中MTX浓度均维持在 0 .6 0～ 2× 10 -4 mol·L-1的范围内。化疗结束 2 4h后血药浓度在 4× 10 -6mol·L-1以下。结论 对大剂量MTX化疗患者进行血药浓度动态监测有利于及时调整给药速度或及时采用解救措施 ,可大大减小大剂量MTX化疗的危险性 ,使患者顺利通过化疗
Objective To monitor the plasma concentration of high dose methotrexate (MTX) chemotherapy in patients with bone and soft tissue tumors in order to ensure that the concentration of MTX in the whole course of chemotherapy is at a suitable therapeutic concentration. And to stop the high concentration of MTX in vivo elimination rule in the study to provide the basis for clinical MTX toxicity reduction. Methods The concentration of MTX in serum was determined by HPLC, and the infusion rate was adjusted based on the measurement results. Pharmacokinetic parameters were calculated by 3P87 pharmacokinetic model fitting to the plasma concentration time data of 0 ~ 24 hours after chemotherapy. Results The concentration of MTX in serum was determined quickly and accurately by HPLC, and the drug delivery rate could be adjusted in time. The MTX concentration in most patients was maintained within the range of 0 60 × 2 × 10 -4 mol·L -1. After the end of chemotherapy 4 4h plasma concentration below 4 × 10 -6mol · L-1. Conclusions The dynamic monitoring of plasma concentration of high-dose MTX chemotherapy is beneficial to promptly adjust the speed of drug delivery or timely rescue measures can greatly reduce the risk of high-dose MTX chemotherapy, so that patients successfully through chemotherapy