| 引用本文： |
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杨蓉,谢晓恬,蒋莎义,等.大剂量阿糖胞苷治疗时药物血浓度与临床反应的关系研究[J].同济大学学报（医学版）,2010,31(4):62-65. [点击复制]
- YANG Rong,XIE Xiao-tian,JIANG Sha-yi,et al.Study on clinical responses and pharmokinetics of cytarabine following its high dose administration[J].同济大学学报（医学版）,2010,31(4):62-65. [点击复制]
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| 摘要: |
| 目的检测急性白血病（acute leukemia，AL）及晚期非霍奇金淋巴瘤（aggressive non—Hodgkin’s lymphoma，NHL）患儿静脉滴注大剂量阿糖胞苷（high-dosec ytarabine，HD-AraC）后2h外周血中阿糖胞苷（Ara-C）、阿糖尿苷（Ara—U）的浓度，同时收集患儿使用HD-AraC后的临床资料，探索Ara—C、Ara-U血浆峰浓度与骨髓抑制及临床疗效的关系。方法采用高效液相色谱法（high performanceliquid chromatography，HPLC）和Ara—C、Ara—U标准品测定静脉滴注HD—AraC后2h外周血中Ara—C、Ara—U的浓度，收集患儿使用HD—AraC后的临床资料，统计分析检测结果。结果静脉滴注HD—AraC后，Ara—C血浆峰浓度与骨髓抑制严重程度（粒细胞绝对值最低值、血小板最低值、骨髓抑制持续时间）之间差异未见有统计学意义（P〉0．05）。患儿Ara—C、Ara—U血浆峰浓度与临床疗效之间差异未见有统计学意义（P〉0．05）。结论HD—AraC治疗时，Ara—C血浆峰浓度的高低与骨髓抑制程度之间无相关性，提示需要进一步测定细胞膜核苷转运系统和细胞内Ara—C有效活性成分阿糖胞苷三磷酸（Ara—CTe）以及与DNA结合的Ara—C的有效浓度，方能阐明Ara—C的个体代谢特征。由于随访时间有限，目前绝大多数患儿仍处于完全缓解（complete remission，CR）期，故有关血浆Ara—C、Ara—U浓度与远期疗效的关系，有待继续化疗与随访后，方能获得分析结果。 |
| 关键词: 药物血浓度 临床反应 大剂量阿糖胞苷 |
| DOI： |
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| 基金项目:上海市科委资助项目（09411964000) |
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| Study on clinical responses and pharmokinetics of cytarabine following its high dose administration |
| YANG Rong1,XIE Xiao-tian2,JIANG Sha-yi2,SHI Wei2,ZHANG Hong3,ZHOU Xiao-xun2 |
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| Abstract: |
| Objective To study the correlations between the concentrations of cytarabine （Ara-C） and uracil arabinoside （Ara-U） in plasma and clinical outcomes and myelosuppression. Methods HPLC was used to measure the concentrations of Ara-C and Ara-U in plasma from acute leukemia and aggressive non-Hodgkin lymphoma in children treated with high dose of Ara-C （HD-AraC）. The adverse effects were also monitored from children who were receiving HD-AraC （2.0 g/m^2 ） infusion. Results There was no correlation found between the peak values of Ara-C in plasma and the severity of myelosuppression. Furthermore, no correlation was found between therapeutic effects and the peak values of either Ara-C or Ara-U in plasma. Conclusion No correlation exists between the peak concentrations of Ara-C in plasma and the degree of myelosuppression. The results suggest that effective concentrations in the cell should be monitored by measuring the activities of nucleoside transporters, or the intracellular concentrations of Ara-CTP and the levels of incorporation of Ara-C into leukemic cell DNA. The correlation between the concentrations of Ara-C and Ara-U in plasma and forward efficacy will be guaranteed when further follow-ups are performed. |
| Key words: drug concentration clinical response high-dose cytarabine |
