骨肉瘤患者行大剂量甲氨蝶呤化疗后24小时血药浓度分析及其临床意义

目的：根据使用大剂量甲氨蝶呤进行化疗的骨肉瘤患者24 h血药浓度值（C_24h），对有可能发生延迟排泄的患者进行提前预警，与临床协作对患者后续的治疗方案及时进行调整，并且为今后制定更加合理的MTX解救流程提供数据支持。方法：对某院2010年8月至2015年8月进行甲氨蝶呤血药浓度监测的骨肉瘤患者的C_24h数据共3515例进行分析，并研究C_24h与延迟排泄的关系。结果：C_24h具有一定规律性，与甲氨蝶呤血药浓度达标所需时间成正相关。建立C_24h危急值报告制度对调整后续治疗方案及患者用药安全预警具有一定实际意义。结论：应通过监测C_24h及时调整后续治疗方案，并对高血药浓度患者尽早处理，防止对患者造成严重损伤。

Analysis of plasma concentration 24 hours after administering high dose methotrexate against osteosarcoma and its clinical significance

OBJECTIVE According to plasma concentration 24 hours after administering high dose methotrexate (C_24h), to prewarn a high risk of delayed methotrexate excretion for the purpose that adjustment of therapeutic scheme should be done in time, and provide statistical data to develop reasonable rescue process.METHODS A total of 3515 results of plasma concentration were analyzed to find out relationship between value of plasma concentration and risk of delayed methotrexate excretion.RESULTS C_24h had a regularity that it positively correlated with time required for plasma concentration reaching the standard, which had a clinical significance to adjustment of therapeutic scheme and pre-warning medication safety.CONCLUSION C_24h monitoring can be utilized to timely adjust therapeutic scheme, prevent serious damage to patients who have high methotrexate plasma concentrations.