大剂量甲氨蝶呤化疗后消除延迟的影响因素和发生机制的研究进展

大剂量甲氨蝶呤（high-dose methotrexate，HD-MTX）化疗后可能出现消除延迟，并造成骨髓抑制、黏膜损伤、肝肾功能损害等严重不良反应。如何减少消除延迟的发生，并通过预防和解救措施，将患者的身体损害减至最小是HD-MTX化疗的关键问题之一。本文总结文献并结合临床实际，从患者生理状态、药物代谢酶、转运体、药物相互作用等方面，探讨HD-MTX化疗后消除延迟的发生机制和解救方法。

Research Progress on the Influencing Factors and Mechanism of Elimination Delay after High-dose Methotrexate Chemotherapy

Elimination delay may happen after high-dose methotrexate (HD-MTX) chemotherapy, and thus causes serious adverse reactions such as bone marrow suppression, mucosal damage, liver and kidney dysfunction, etc. The prevention and emergency rescue of elimination delay remains the key-point for HD-MTX chemotherapy so as to minimize body damage of patients.In combination with clinical practice, this paper summarized literatures on the mechanism and treatment of elimination delay after HD-MTX chemotherapy from the aspects of physiological state of patients, drug metabolism enzymes, transporters and drug interactions.