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目的探讨急性淋巴细胞性白血病(ALL)患儿大剂量甲氨喋呤(HD-MTX)化疗后小剂量四氢叶酸钙(CF)解救的可能性。方法将15例确诊ALL患儿按随机数字表法分为观察组和对照组,观察组8例患儿36例次的HD-MTX化疗后CF的解救剂量减少至1.5%,对照组7例患儿的31例次解救剂量仍为常规的2.5%。观察所有患儿的毒副反应,并监测血药浓度。结果观察组8例患儿的36例次化疗中,5例次发生呕吐,2例次发生口腔黏膜溃烂;2例次68hMTX血药浓度明显高于0.1μmol/L。对照组7例患儿的31例次化疗中,3例次发生呕吐,2例次发生口腔黏膜溃烂;1例次68hMTX血药浓度明显高于0.1μmol/L。2组毒副反应发生率及血药浓度异常发生率比较差异无统计学意义(P均>0.05)。结论小剂量CF解救HD-MTX比较安全。
Objective To investigate the possibility of rescuing small doses of calcium hydrate (CF) after high-dose methotrexate (HD-MTX) chemotherapy in children with acute lymphoblastic leukemia (ALL). Methods Fifteen children diagnosed with ALL were randomly divided into observation group and control group according to random number table. The rescue dose of CF after HD-MTX chemotherapy was reduced to 1.5% in 36 cases in 8 cases in observation group, and 7 cases in control group The 31 cases of children rescued dose is still 2.5% conventional. All children were observed for side effects and plasma concentrations were monitored. Results In the 36 cases of chemotherapy in 8 cases, vomiting occurred in 5 cases and ulceration of oral mucosa in 2 cases. The plasma concentration of 68hMTX in 2 cases was significantly higher than that of 0.1μmol / L. Thirty-one patients in the control group received vomiting in 3 of the 31 cases. Oral mucosal ulceration occurred in 2 patients. The plasma concentration of 68hMTX in 1 patient was significantly higher than that of 0.1μmol / L. There was no significant difference in the incidence of side effects and abnormalities of plasma concentrations between the two groups (all P> 0.05). Conclusion Low-dose CF rescue HD-MTX safer.