中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
3期
397-399
,共3页
儿童白血病%甲氨蝶呤%大剂量
兒童白血病%甲氨蝶呤%大劑量
인동백혈병%갑안접령%대제량
Childhood leukemia%Methotrexate%High-dose
目的 分析应用大剂量甲氨蝶呤治疗儿童急性淋巴细胞白血病(ALL)的临床效果.方法对31例标危型和27例中高危型ALL患儿分别采用中剂量(3 g/m2,静脉滴注,1次/10 d)、高剂量(5 g/m2,静脉滴注,1次/10 d)甲氨蝶呤治疗,监测其血药浓度和排泄延迟率,观察不良反应发生情况以及治愈率.结果中剂量组44 h血药浓度(1.21±0.23)μmol/L,68 h血药浓度(0.39±0.14)μmol/L,高剂量分别是(1.02±0.21)和(0.21±0.09)μmol/L,2组差异有统计学意义(t=6.010、7.123,P＜0.01);排泄延迟率2组差异无统计学意义(P＞0.05);中剂量组和高剂量组均可发生皮肤损坏、黏膜炎、肝肾功能损害、消化道反应、血液学改变、感染等并发症;总的治愈率为79.3%(46/58),中高危型患儿的治愈率为66.7%(18/27),标危型患儿的治愈率为90.3%(28/31),明显高于中高危型患儿(66.7%)(18/27),差异有统计学意义(χ2=17.95,P＜0.05).2组不良反应比较差异无统计学意义(P>0.05).结论 大剂量甲氨蝶呤治疗儿童ALL可提高治疗效果.
目的 分析應用大劑量甲氨蝶呤治療兒童急性淋巴細胞白血病(ALL)的臨床效果.方法對31例標危型和27例中高危型ALL患兒分彆採用中劑量(3 g/m2,靜脈滴註,1次/10 d)、高劑量(5 g/m2,靜脈滴註,1次/10 d)甲氨蝶呤治療,鑑測其血藥濃度和排洩延遲率,觀察不良反應髮生情況以及治愈率.結果中劑量組44 h血藥濃度(1.21±0.23)μmol/L,68 h血藥濃度(0.39±0.14)μmol/L,高劑量分彆是(1.02±0.21)和(0.21±0.09)μmol/L,2組差異有統計學意義(t=6.010、7.123,P＜0.01);排洩延遲率2組差異無統計學意義(P＞0.05);中劑量組和高劑量組均可髮生皮膚損壞、黏膜炎、肝腎功能損害、消化道反應、血液學改變、感染等併髮癥;總的治愈率為79.3%(46/58),中高危型患兒的治愈率為66.7%(18/27),標危型患兒的治愈率為90.3%(28/31),明顯高于中高危型患兒(66.7%)(18/27),差異有統計學意義(χ2=17.95,P＜0.05).2組不良反應比較差異無統計學意義(P>0.05).結論 大劑量甲氨蝶呤治療兒童ALL可提高治療效果.
목적 분석응용대제량갑안접령치료인동급성림파세포백혈병(ALL)적림상효과.방법대31례표위형화27례중고위형ALL환인분별채용중제량(3 g/m2,정맥적주,1차/10 d)、고제량(5 g/m2,정맥적주,1차/10 d)갑안접령치료,감측기혈약농도화배설연지솔,관찰불량반응발생정황이급치유솔.결과중제량조44 h혈약농도(1.21±0.23)μmol/L,68 h혈약농도(0.39±0.14)μmol/L,고제량분별시(1.02±0.21)화(0.21±0.09)μmol/L,2조차이유통계학의의(t=6.010、7.123,P＜0.01);배설연지솔2조차이무통계학의의(P＞0.05);중제량조화고제량조균가발생피부손배、점막염、간신공능손해、소화도반응、혈액학개변、감염등병발증;총적치유솔위79.3%(46/58),중고위형환인적치유솔위66.7%(18/27),표위형환인적치유솔위90.3%(28/31),명현고우중고위형환인(66.7%)(18/27),차이유통계학의의(χ2=17.95,P＜0.05).2조불량반응비교차이무통계학의의(P>0.05).결론 대제량갑안접령치료인동ALL가제고치료효과.
Objective To study the effect of the treatment for childhood leukemia with high-dose methotrexate. Methods Totally 58 cases of children patients in Yichang second people's hospital of Hubei Province were observed regarding the clinical effect of the middle-high-dose middle-dose(3 g/m2, intravenous injection, every ten days time) regarding high-dose(5 g/m2, intravenous injection, every ten days time) methotrexate in the treatment. The blood concentration, discharge delay rate and adverse reaction were monitored. Results The plasma concentration of middle-dose group in 44 h and 68 h was (1.21±0.23) μmol/L and (0.39±0.14) μmol/L; it was (1.02±0.21) μmol/L and (0.21±0.09) μmol/L in high-dose group. The data of the two groups was significantly different (t=6.0104, 7.1231, P＜0.01). The discharge delay rate of the two groups were different with statistical significance. The two groups had adverse reactions of skin damage,blennophlogisma, liver and kidney function damage, the digestive tract reaction, the change of the hematology and infection. The total cure rate was 79.3%, the cure rate in children with middle-high-risk type was 66.7%(18/27); the cure rate in children with standard-risk type was 90.3%(28/31), which was significantly higher than that in high-risk patients (66.7%)(18/27)(χ2=17.95, P<0.05). Conclusion The application of treatment of high-dose methotrexate for children with childhood leukemia can effectively improve the treatment effect and reduce the degree of adverse reactions.
