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氨甲蝶呤(Methotrexate,MTX)最初应用于癌症的治疗,后来用于治疗银屑病以及银屑病性关节炎,十多年来,成为治疗风湿性疾病的主要药物之一。现就其在儿童风湿性疾病中的应用简介如下。1 作用机制 目前认为,MTX抗风湿作用机制可能为:①作为二氢叶酸还原酶抑制剂,阻止二氢叶酸转变成四氢叶酸,从而抑制细胞DNA和RNA的合成,促使淋巴细胞等炎症细胞死亡,尤其是快速裂解细胞。②通过促使炎症部位腺苷的释放,引起5-氨基咪唑-4碳酰胺-核糖核苷酸在细胞内的聚集,后者作用于腺苷A_2受体,通
Methotrexate (MTX), originally used in the treatment of cancer and later used in the treatment of psoriasis and psoriatic arthritis, has for over a decade been one of the major drugs for the treatment of rheumatic diseases. Now on its application in children with rheumatic diseases are as follows. 1 mechanism of action Currently, MTX anti-rheumatic mechanisms may be: ① as a dihydrofolate reductase inhibitor, to prevent the conversion of dihydrofolate into tetrahydrofolate, thereby inhibiting the synthesis of DNA and RNA and promote the death of inflammatory cells such as lymphocytes Especially fast lysis of cells. ② by promoting the release of adenosine at the inflammation site, causing 5-amino-imidazole-4-carboxamide-ribonucleotides in cells, the latter acting on adenosine A2 receptors,