CAJ | 학술논문

目的：观察大剂量甲氨蝶呤（HD-MTX）及亚叶酸钙（CF）不同应用方式在淋巴瘤患者中的疗效和毒副作用。方法回顾性分析2010年1月～2014年12月于我院应用HD-MTX化疗的淋巴瘤患者83例，根据用药方式不同分为两组，一组为甲氨蝶呤静脉点滴4h，结束6h后开始解救，简称短期早解救组，二组为甲氨蝶呤持续静脉滴注24h，结束12h后开始解救，简称长期晚解救组，对比两组患者的疗效及毒副作用。结果两组患者化疗有效率分别为85.0%（34/40）和65.1%（28/43），差异有统计学意义（P=0.037），短期早解救组Ⅲ～Ⅳ级消化道反应发生率、白细胞下降率、血红蛋白下降率、血小板下降率、粒缺并感染发生率均较长期晚解救组低，差异具有统计学意义（P＜0.05）。结论大剂量甲氨蝶呤短期早解救在淋巴瘤患者应用中疗效好，且毒副作用较长期晚解救组少，值得临床推广。
목적：관찰대제량갑안접령（HD-MTX）급아협산개（CF）불동응용방식재림파류환자중적료효화독부작용。방법회고성분석2010년1월～2014년12월우아원응용HD-MTX화료적림파류환자83례，근거용약방식불동분위량조，일조위갑안접령정맥점적4h，결속6h후개시해구，간칭단기조해구조，이조위갑안접령지속정맥적주24h，결속12h후개시해구，간칭장기만해구조，대비량조환자적료효급독부작용。결과량조환자화료유효솔분별위85.0%（34/40）화65.1%（28/43），차이유통계학의의（P=0.037），단기조해구조Ⅲ～Ⅳ급소화도반응발생솔、백세포하강솔、혈홍단백하강솔、혈소판하강솔、립결병감염발생솔균교장기만해구조저，차이구유통계학의의（P＜0.05）。결론대제량갑안접령단기조해구재림파류환자응용중료효호，차독부작용교장기만해구조소，치득림상추엄。
Objective To observe the curative effects and toxic side effects of different application methods of high-dose methotrexate (HD-MTX) and calcium folinate (CF) in the treatment of lymphoma.Methods 83 patients with lymphoma who were received HD-MTX chemotherapy in our hospital from January 2010 to December 2014 were retrospectively analyzed and they were allocated to two groups according to medication methods. The first group as short-term early rescue group was received methotrexate intravenous drip for 4 hours and started to rescue after 6 hours. The second group as the long-term late rescue group was received methotrexate by continuous intravenous drip for 24 hours and started to rescue after 1 hour. The curative effects and toxic side effects of two groups were compared. Results Chemotherapeutic effective rates of two groups were 85.0% (34/40) and 65.1% (28/43) respectively, and the difference was statistically significant(P=0.037). Level ⅢtoⅣ digestive tract reaction rate, the decreasing rate of white blood cells, the decreasing rate of hemoglobin, the decreasing rate of platelet, agranulocytosis and infection incidence rate were all lower than those in the long-term late rescue group, the differences were statistically significant(P<0.05).Conclusion Short-term early rescue of high-dose methotrexate in treatment of patients with lymphoma has a good curative effect and less toxic side effects which are lower than those in the long-term late rescue group. It is worthy of clinical promotion.