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目的:观察研究将大剂量甲氨蝶呤(HD-MTX)应用于儿童急性白血病临床治疗的实际疗效以及安全性。方法:从2008年12月到2013年12月之间在我院进行治疗的不同程度急性白血病患儿中随机选取30例病例,根据患儿病情情况分为标危组与中高危组,并观察两组患儿用药后在不同时间内的血药浓度和药物治疗后不良反应的发生情况。结果:标危组患儿在用药后44h时血药浓度为(1.13±0.35)μmol/L,68h时血药浓度为(0.42±0.19)μmol/L,中高组这两个时间点血药浓度为(0.83±0.29)μmol/L和(0.22±0.18)μmol/L。两组患儿68h时血药浓度明显低于44h时血药浓度(p<0.05);此外两组患儿不良反应以及排泄延迟的发生情况均没有显著差异(p>0.05)。结论:将HD-MTX应用于儿童急性白血病临床治疗,可有效提高治疗效果,并减轻患儿不良反应发生程度。
Objective: To observe the clinical efficacy and safety of high-dose methotrexate (HD-MTX) in the clinical treatment of childhood acute leukemia. Methods: From December 2008 to December 2013 in our hospital for treatment of different degrees of acute leukemia in children randomly selected 30 cases, according to the condition of children were divided into standard risk group and high risk group, and observed Two groups of children with medication at different times after the blood concentration and adverse drug reactions after treatment. Results: The plasma concentration of (1.13 ± 0.35) μmol / L at 44h after treatment in standard risk group was (0.42 ± 0.19) μmol / L at 68h, and the plasma concentration (0.83 ± 0.29) μmol / L and (0.22 ± 0.18) μmol / L respectively. The blood concentration of 68h in both groups was significantly lower than that in 44h (p <0.05). There was no significant difference in adverse reaction and excretion delay in both groups (p> 0.05). Conclusion: The application of HD-MTX in clinical treatment of childhood acute leukemia can effectively improve the therapeutic effect and reduce the incidence of adverse reactions in children.