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某三甲儿童医院甲氨蝶呤血药浓度监测及影响因素分析
孙丽,任玲,安琪,刘红
0
(徐州医科大学附属儿童医院,江苏徐州 221000)
摘要:
[摘要]目的:监测我院使用大剂量甲氨蝶呤治疗的急性淋巴细胞白血病及淋巴瘤患儿的血药浓度,并对影响因素进行分析。方法:采用回顾性研究方法,收集我院2015年6月至2017年9月使用大剂量甲氨蝶呤治疗的急性淋巴性白血病及淋巴瘤患儿的血药浓度监测报告共121份,归纳整理分析结果,探讨其影响因素。结果:121例甲氨蝶呤血药浓度监测报告中,24 h浓度有16例(13.22%)超过危急值,最高值达72.36 µmol/L;48 h、72 h浓度均能够维持在安全浓度范围内,无超过危急值情况。尿液碱化对甲氨蝶呤的24 h浓度影响显著(P<0.01)。结论:我院应进一步规范甲氨蝶呤使用方法,注意尿液碱化,加强药物浓度监测,以确保患儿用药安全。
关键词:  甲氨蝶呤  血药浓度监测  影响因素
DOI:doi:10.13407/j.cnki.jpp.1672-108X.2019.02.013
基金项目:
Monitoring and Influencing Factors of Methotrexate Blood Concentration in a Grade III Level A Hospital
Sun Li, Ren Ling, An Qi, Liu Hong
(Xuzhou Children's Hospital of Xuzhou Medical University, Jiangsu Xuzhou 221000, China)
Abstract:
[Abstract] Objective: To monitor the blood concentration of children with acute lymphoblastic leukemia and lymphoma treated with high-dose methotrexate in our hospital, and to analyze the influencing factors. Methods: Retrospective statistical analysis method was adopted. A total of 121 blood concentration monitoring reports were collected from children with acute lymphocytic leukemia and lymphoma treated with high-dose methotrexate in our hospital from June 2015 to Sept. 2017, the results of the analysis were summarized and the influencing factors were discussed. Results: Of the 121 cases of methotrexate blood concentration monitoring reports, 16 cases (13.22%) with the 24 h blood concentration exceeded the critical value, the highest value reached 72.36 μmol/L. The blood concentration at 48 h and 72 h can be maintained within the safe range without exceeding the critical value. Urine alkalization had a significant effect on the 24 h blood concentration of methotrexate (P<0.01). Conclusion: Our hospital should further standardize the use of methotrexate, pay attention to the urine alkalization, and strengthen the blood concentration monitoring to ensure the safety of children.
Key words:  methotrexate  blood concentration monitoring  influencing factors

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