Article(id=1292126548690235911, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292126460546929080, articleNumber=null, orderNo=null, doi=10.13699/j.cnki.1001-6821.2026.03.006, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1747065600000, receivedDateStr=2025-05-13, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1785996575757, onlineDateStr=2026-08-06, pubDate=1771257600000, pubDateStr=2026-02-17, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1785996575757, onlineIssueDateStr=2026-08-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1785996575757, creator=13701087609, updateTime=1785996575757, updator=13701087609, issue=Issue{id=1292126460546929080, tenantId=1146029695717560320, journalId=1246415772164075586, year='2026', volume='42', issue='3', pageStart='301', pageEnd='450', issueExtLink='null', onlineDate='null', pubDate='1771257600000', pubDateStr='2026-02-17', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1785996554742, creator='13701087609', updateTime=1786014541627, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1292201903060963536, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292126460546929080, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1292201903060963537, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1292126460546929080, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=333, endPage=337, ext={EN=ArticleExt(id=1292126548912534024, articleId=1292126548690235911, tenantId=1146029695717560320, journalId=1246415772164075586, language=EN, title=Clinical study on severe delayed excretion complicated with acute kidney injury in hematological malignancies treated with high-dose methotrexate, columnId=1246531407326105792, journalTitle=Chinese Journal of Clinical Pharmacology, columnName=Clinical and Basic Bridging Research, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the occurrence and risk factors of acute kidney injury (AKI) in patients with hematologic malignancies who experienced severe delayed excretion after high-dose methotrexate (HD-MTX) chemotherapy, and to explore dose adjustment strategies for reusing HD-MTX in these patients.

Methods

A retrospective analysis was conducted on clinical data of hematologic malignancy patients treated with HD-MTX in the hematology and oncology departments. Patients with severe delayed MTX excretion (defined as serum MTX >30 μmol·L-1 at 24 h, >3 μmol·L-1 at 48 h, >0.3 μmol·L-1 at 72 h, or prolonged low-level MTX >0.3 μmol·L-1 for >6 days) were included. Patients were divided into three groups based on AKI severity, group A was mild AKI, group B was moderate AKT, group C was severe AKI. Statistical methods were used to analyze risk factors for severe excretion delay and AKI.

Results

Among 26 patients (28 HD-MTX cycles) with severe delayed excretion, AKI occurred in all cycles (100.00%). Group A accounted for 21.43% (6 cases/28 cases), Group B accounted for 46.43% (13 cases/28 cases), accounted for 32.14% (9 cases/28 cases). Pre-treatment albumin levels in group A, group B and group C were (42.22±4.63), (39.08±4.3) and (35.25±4.19) g·L-1. Among patients with moderate/severe AKI, 11 received 19 subsequent HD-MTX cycles at reduced doses (1/3-1× original), with no recurrence of excretion delay or AKI.

Conclusion

Low pre-treatment albumin levels, particularly <35 g·L-1 are strongly associated with severe MTX-related AKI. Patients with a history of MTX-induced AKI can safely reuse HD-MTX at adjusted doses (based on renal recovery and clinical indicators) without AKI recurrence.

, authors=Qiao-yan LIa, Ai-ling MAa, Yi-meng WANGa, Dan YANGa, Xiang-li CHENb, authorsList=Qiao-yan LI, Ai-ling MA, Yi-meng WANG, Dan YANG, Xiang-li CHEN, authorCompany=null, correspAuthors=Xiang-li CHEN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1292126549189358089, articleId=1292126548690235911, tenantId=1146029695717560320, journalId=1246415772164075586, language=CN, title=大剂量甲氨蝶呤治疗恶性血液系统肿瘤中排泄重度延迟并发急性肾损伤的临床研究, columnId=1246531407485489349, journalTitle=中国临床药理学杂志, columnName=临床与基础桥接研究, runingTitle=null, highlight=null, articleAbstract=
目的

观察血液系统恶性肿瘤患者使用大剂量甲氨蝶呤(HD-MTX)化疗方案发生重度排泄延迟时,急性肾损伤(AKI)的发生情况与风险因素,并探讨此类患者发生药物不良反应后再次使用HD-MTX方案时的剂量调整策略。

方法

以本院血液内科和肿瘤内科就诊的、使用HD-MTX化疗方案的血液系统恶性肿瘤患者为研究对象,筛选发生重度排泄延迟(MTX滴注结束24 h时,血药浓度大于30 μmol·L-1,或48 h时,血药浓度大于3 μmol·L-1,或72 h时,血药浓度大于0.3 μmol·L-1,或谷浓度>0.3 μmol·L-1持续时间大于6天)的患者,根据患者用药后相关临床指标以及治疗方案将患者分为3组,A组为轻度AKI组;B组为中度AKI组;C组为重度AKI组,应用统计学方法分析患者发生排泄重度延迟以及AKI的风险因素。

结果

本研究入组的26例患者在28个HD-MTX治疗周期中均发生了甲氨蝶呤重度排泄延迟,此28个周期均出现了不同程度的AKI(100.00%),A组占21.43%(6个/28个);B组占46.43%(13个/28个);C组占32.14%(9个/28个)。给药前,A组、B组和C组的白蛋白水平分别为(42.22±4.63),(39.08±4.26)和(35.25±4.19)g·L-1,A组与C组比较,在统计学上差异有统计学意义(P<0.05)。经统计学分析发现,患者使用HD-MTX方案前的白蛋白水平与肾损伤程度在统计学上有显著相关性,白蛋白水平越低的患者发生发生中重度肾损伤的风险越高。发生中重度AKI的患者在后续治疗中有11位患者接受了19个周期的HD-MTX方案,甲氨蝶呤剂量在原剂量的1/3~1倍内波动,均未再发生排泄延迟以及AKI。

结论

恶性血液系统肿瘤患者使用大剂量甲氨蝶呤化疗方案时,用药前白蛋白水平与患者发生肾损伤的风险密切相关,白蛋白水平越低肾损伤程度越高。有MTX相关的中重度肾损伤病史的患者,在肾功能恢复后,可以根据患者临床指标降低剂量或维持原剂量继续使用HD-MTX方案,并不会发生AKI。

, authors=李巧艳a, 马爱玲a, 王漪檬a, 杨丹a, 陈香丽b, authorsList=李巧艳, 马爱玲, 王漪檬, 杨丹, 陈香丽, authorCompany=null, correspAuthors=陈香丽, authorNote=

李巧艳(1985-),女,副主任药师,主要从事临床个体化用药相关的工作和研究

, correspAuthorsNote=
陈香丽,主任医师,硕士生导师 Tel: (0371)65897521 E-mail:
, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=8vP+EG8ildq51BG+0KTmWA==, magXml=zq6NcFeMet/CxRVqAIen9g==, pdfUrl=null, pdf=CjAuoFy3bVQBYvF/YY6Idg==, pdfFileSize=1599311, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=R5cUb8wfWt7gXMkYfwbm1w==, mapNumber=null, fund=null)}, authors=[Author(id=1292126549885612561, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1292126549952721427, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126549885612561, language=EN, stringName=Qiao-yan LI, firstName=Qiao-yan, middleName=null, lastName=LI, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=a, address=a.Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1292126550204379668, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126549885612561, language=CN, stringName=李巧艳, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=a, address=a.河南省人民医院 药学部,河南 郑州 450003, bio={"content":"

李巧艳(1985-),女,副主任药师,主要从事临床个体化用药相关的工作和研究

"}, bioImg=null, bioContent=

李巧艳(1985-),女,副主任药师,主要从事临床个体化用药相关的工作和研究

, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1292126549524902410, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, xref=a., ext=[AuthorCompanyExt(id=1292126549533291019, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549524902410, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China), AuthorCompanyExt(id=1292126549545873932, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549524902410, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.河南省人民医院 药学部,河南 郑州 450003)])]), Author(id=1292126550279877142, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, orderNo=1, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1292126550367957528, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126550279877142, language=EN, stringName=Ai-ling MA, firstName=Ai-ling, middleName=null, lastName=MA, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=a, address=a.Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1292126552062456345, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126550279877142, language=CN, stringName=马爱玲, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=a, address=a.河南省人民医院 药学部,河南 郑州 450003, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1292126549524902410, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, xref=a., ext=[AuthorCompanyExt(id=1292126549533291019, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549524902410, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China), AuthorCompanyExt(id=1292126549545873932, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549524902410, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.河南省人民医院 药学部,河南 郑州 450003)])]), Author(id=1292126552150536731, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, orderNo=2, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1292126552284754461, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126552150536731, language=EN, stringName=Yi-meng WANG, firstName=Yi-meng, middleName=null, lastName=WANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=a, address=a.Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1292126552351863326, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126552150536731, language=CN, stringName=王漪檬, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=a, address=a.河南省人民医院 药学部,河南 郑州 450003, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1292126549524902410, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, xref=a., ext=[AuthorCompanyExt(id=1292126549533291019, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549524902410, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China), AuthorCompanyExt(id=1292126549545873932, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549524902410, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.河南省人民医院 药学部,河南 郑州 450003)])]), Author(id=1292126552427360800, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, orderNo=3, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1292126552511246882, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126552427360800, language=EN, stringName=Dan YANG, firstName=Dan, middleName=null, lastName=YANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=a, address=a.Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1292126552595132963, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126552427360800, language=CN, stringName=杨丹, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=a, address=a.河南省人民医院 药学部,河南 郑州 450003, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1292126549524902410, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, xref=a., ext=[AuthorCompanyExt(id=1292126549533291019, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549524902410, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China), AuthorCompanyExt(id=1292126549545873932, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549524902410, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.河南省人民医院 药学部,河南 郑州 450003)])]), Author(id=1292126552758710821, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, orderNo=4, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=snowdrop999@163.com, emailSecond=null, emailThird=null, correspondingAuthor=1, authorType=1, ext={EN=AuthorExt(id=1292126552842596903, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126552758710821, language=EN, stringName=Xiang-li CHEN, firstName=Xiang-li, middleName=null, lastName=CHEN, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=b, address=b.Department of Hematology, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1292126552913900072, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126552758710821, language=CN, stringName=陈香丽, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=b, address=b.河南省人民医院 血液内科,河南 郑州 450003, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1292126549801726477, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, xref=b., ext=[AuthorCompanyExt(id=1292126549810115086, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549801726477, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=b.Department of Hematology, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China), AuthorCompanyExt(id=1292126549818503695, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549801726477, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=b.河南省人民医院 血液内科,河南 郑州 450003)])])], keywords=[Keyword(id=1292126553043923497, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, language=EN, orderNo=1, keyword=high-dose methotrexate), Keyword(id=1292126553194918442, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, language=EN, orderNo=2, keyword=albumin level), Keyword(id=1292126553262027307, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, language=EN, orderNo=3, keyword=kidney injury), Keyword(id=1292126553337524780, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, language=EN, orderNo=4, keyword=dose adjustment), Keyword(id=1292126553396245037, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, language=CN, orderNo=1, keyword=大剂量甲氨蝶呤), Keyword(id=1292126553459159598, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, language=CN, orderNo=2, keyword=白蛋白水平), Keyword(id=1292126553614348847, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, language=CN, orderNo=3, keyword=肾损伤), Keyword(id=1292126553668874800, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, language=CN, orderNo=4, keyword=剂量调整)], refs=null, funds=null, companyList=[AuthorCompany(id=1292126549524902410, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, xref=a., ext=[AuthorCompanyExt(id=1292126549533291019, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549524902410, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China), AuthorCompanyExt(id=1292126549545873932, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549524902410, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.河南省人民医院 药学部,河南 郑州 450003)]), AuthorCompany(id=1292126549801726477, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, xref=b., ext=[AuthorCompanyExt(id=1292126549810115086, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549801726477, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=b.Department of Hematology, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China), AuthorCompanyExt(id=1292126549818503695, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549801726477, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=b.河南省人民医院 血液内科,河南 郑州 450003)])], figs=null, attaches=null, journal=Journal(id=1246415058658443328, delFlag=0, nameCn=中国临床药理学杂志, nameEn=Chinese Journal of Clinical Pharmacology, nameHistory1=null, nameHistory2=null, issn=1001-6821, eissn=null, cn=11-2220/R, coden=null, periodic=3, language=CN, oaType=null, ccby=null, superviseOffice=null, ownerOffice=null, pubOffice=null, editorOffice=null, officeType=null, aims=null, clcCode=null, officeProv=null, officeCity=null, officeAddr=null, officeZip=null, officeEmail=null, officePhone=null, editDirector=null, officeDirector=null, officeDirectorPhone=null, officeStaffNum=null, officeEmpNum=null, coverPicUrl=8cEfS7jvj/ukyhKVOMJePA==, journalPrice=null, startedYear=null, abbrevIsoEn=Chinese Journal of Clinical Pharmacology, journalRemark=null, publicationField=null, createdTime=1775098107259, updatedTime=1788948995538, createdBy=18614031015, updatedBy=13041195026, firstLetterCn=Z, firstLetterEn=Z, subjectCode=Medical and Pharmaceutical Sciences, subjectName=null, subjectCodeEn=Medical and Pharmaceutical Sciences, subjectNameEn=null, picCn=8cEfS7jvj/ukyhKVOMJePA==, picEn=cQ12tu98gbNetbFuefeYGg==, jcr=null, cjcr=null, exts=[JournalExt(id=1304509895005466898, language=CN, name=中国临床药理学杂志, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1788948995591, updatedTime=1788948995591, createdBy=13041195026, updatedBy=13041195026, submissionGuidelinesUrl=, submissionAuthorUrl=https://lcylauthor.cast.org.cn/webm, submissionEditorUrl=https://lcyleditor.cast.org.cn/webm, submissionReviewUrl=https://lcylauthor.cast.org.cn/webm, submissionCeEditorUrl=https://lcyleditor.cast.org.cn/webm, submissionAeEditorUrl=https://lcyleditor.cast.org.cn/webm, option={"copyright":""}), JournalExt(id=1304509895047409939, language=EN, name=Chinese Journal of Clinical Pharmacology, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1788948995601, updatedTime=1788948995601, createdBy=13041195026, updatedBy=13041195026, submissionGuidelinesUrl=, submissionAuthorUrl=https://lcylauthor.cast.org.cn/webm, submissionEditorUrl=https://lcyleditor.cast.org.cn/webm, submissionReviewUrl=https://lcylauthor.cast.org.cn/webm, submissionCeEditorUrl=https://lcyleditor.cast.org.cn/webm, submissionAeEditorUrl=https://lcyleditor.cast.org.cn/webm, option={"copyright":""})], databaseList=null, tenantJournalId=1246415772164075586, websiteList=[Website(id=1246421196657546140, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1246415772164075586, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/zglcylxzz/CN, language=CN, createTime=1775099570670, createBy=18614031015, updateTime=1775099747371, updateBy=18614031015, name=中国临床药理学杂志-中文, tplId=1146099689490845704, title=中国临床药理学杂志, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1246422027293316008, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196657546140, code=articleTextType, value=kx, createTime=1775099768708, updateTime=1775099768708, creator=18614031015, updator=18614031015), WebsiteProps(id=1246422027268150181, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196657546140, code=banner, value=null, createTime=1775099768702, updateTime=1775099768702, creator=18614031015, updator=18614031015), WebsiteProps(id=1246422027310093227, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196657546140, code=grayFlag, value=0, createTime=1775099768712, updateTime=1775099768712, creator=18614031015, updator=18614031015), WebsiteProps(id=1246422027259761572, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196657546140, code=logo, value=https://castjournals.cast.org.cn/joweb/zglcylxzz/CN/file/pic?fileId=KeUk4pyVjfIIkOq40uZX0Q==, createTime=1775099768700, updateTime=1775099768700, creator=18614031015, updator=18614031015), WebsiteProps(id=1246422027322676141, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196657546140, code=minRunFlag, value=0, createTime=1775099768715, updateTime=1775099768715, creator=18614031015, updator=18614031015), WebsiteProps(id=1246422027284927399, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196657546140, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/zglcylxzz/CN/file/pic, createTime=1775099768706, updateTime=1775099768706, creator=18614031015, updator=18614031015), WebsiteProps(id=1246422027318481836, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196657546140, code=silenceFlag, value=0, createTime=1775099768714, updateTime=1775099768714, creator=18614031015, updator=18614031015), WebsiteProps(id=1246422027276538790, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196657546140, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_cn_619/, createTime=1775099768704, updateTime=1775099768704, creator=18614031015, updator=18614031015), WebsiteProps(id=1246422027297510313, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196657546140, code=themeColor, value=null, createTime=1775099768709, updateTime=1775099768709, creator=18614031015, updator=18614031015), WebsiteProps(id=1246422027305898922, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196657546140, code=themeStyle, value=null, createTime=1775099768711, updateTime=1775099768711, creator=18614031015, updator=18614031015)]), Website(id=1246421196871455649, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1246415772164075586, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/zglcylxzz/EN, language=EN, createTime=1775099570720, createBy=18614031015, updateTime=1775099757298, updateBy=18614031015, name=中国临床药理学杂志-英文, tplId=1146101810881728533, title=Chinese Journal of Clinical Pharmacology, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1246422058998059954, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196871455649, code=articleTextType, value=kx, createTime=1775099776267, updateTime=1775099776267, creator=18614031015, updator=18614031015), WebsiteProps(id=1246422058977088431, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196871455649, code=banner, value=null, createTime=1775099776262, updateTime=1775099776262, creator=18614031015, updator=18614031015), WebsiteProps(id=1246422059014837173, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196871455649, code=grayFlag, value=0, createTime=1775099776271, updateTime=1775099776271, creator=18614031015, updator=18614031015), WebsiteProps(id=1246422058968699822, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196871455649, code=logo, value=https://castjournals.cast.org.cn/joweb/zglcylxzz/EN/file/pic?fileId=KeUk4pyVjfIIkOq40uZX0Q==, createTime=1775099776260, updateTime=1775099776260, creator=18614031015, updator=18614031015), WebsiteProps(id=1246422059031614391, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196871455649, code=minRunFlag, value=0, createTime=1775099776275, updateTime=1775099776275, creator=18614031015, updator=18614031015), WebsiteProps(id=1246422058993865649, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196871455649, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/zglcylxzz/EN/file/pic, createTime=1775099776266, updateTime=1775099776266, creator=18614031015, updator=18614031015), WebsiteProps(id=1246422059023225782, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196871455649, code=silenceFlag, value=0, createTime=1775099776273, updateTime=1775099776273, creator=18614031015, updator=18614031015), WebsiteProps(id=1246422058985477040, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196871455649, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_en_623/, createTime=1775099776264, updateTime=1775099776264, creator=18614031015, updator=18614031015), WebsiteProps(id=1246422059002254259, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196871455649, code=themeColor, value=null, createTime=1775099776268, updateTime=1775099776268, creator=18614031015, updator=18614031015), WebsiteProps(id=1246422059010642868, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1246421196871455649, code=themeStyle, value=null, createTime=1775099776270, updateTime=1775099776270, creator=18614031015, updator=18614031015)])], journalTitle=中国临床药理学杂志, weixinUrl=null, journalUrl=null, iacademicId=null, status=1, seqNo=null, journalTitleEn=Chinese Journal of Clinical Pharmacology, journalPhotoCn=8cEfS7jvj/ukyhKVOMJePA==, journalPhotoEn=cQ12tu98gbNetbFuefeYGg==, journalFirstLetter=Z, journalRecommend=null, journalNew=null, journalCollection=null, jcrJf=null, cjcrJf=null, jcrJfStr=null, cjcrJfStr=null, submissionFirstDecision=null, sciSubjectClassification=null, casSubjectClassification=null, citeScore=null, totalCitationFrequency=null, icpCode=null, psCode=null, advertisingLicenseCode=null, copyrightInformation=null, country=null, option=, provinceCode=null, provinceName=null, collectFlag=false, interPubPlatform=, interPubPlatformUrl=null), detailUrlCn=https://castjournals.cast.org.cn/joweb/zglcylxzz/CN/10.13699/j.cnki.1001-6821.2026.03.006, detailUrlEn=https://castjournals.cast.org.cn/joweb/zglcylxzz/EN/10.13699/j.cnki.1001-6821.2026.03.006, pdfUrlCn=https://castjournals.cast.org.cn/joweb/zglcylxzz/CN/PDF/10.13699/j.cnki.1001-6821.2026.03.006, pdfUrlEn=https://castjournals.cast.org.cn/joweb/zglcylxzz/EN/PDF/10.13699/j.cnki.1001-6821.2026.03.006, aliStartDate=0, aliEndDate=0, collectionFlag=false, citedCount=null, citedUrl=null, previewStatus=0, delFlag=0, hasFullText=0, orderTime=1771257600000, fullTextJson=null, articleText=null, reference=null)
收藏切换
大剂量甲氨蝶呤治疗恶性血液系统肿瘤中排泄重度延迟并发急性肾损伤的临床研究
收藏切换
PDF下载
李巧艳 a , 马爱玲 a , 王漪檬 a , 杨丹 a , 陈香丽 b
中国临床药理学杂志 | 临床与基础桥接研究 2026,42(3): 333-337
收起
收藏切换
中国临床药理学杂志 |临床与基础桥接研究 2026 , 42 (3) : 333 -337
大剂量甲氨蝶呤治疗恶性血液系统肿瘤中排泄重度延迟并发急性肾损伤的临床研究
全屏
[Author(id=1292126549885612561, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1292126549952721427, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126549885612561, language=EN, stringName=Qiao-yan LI, firstName=Qiao-yan, middleName=null, lastName=LI, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=a, address=a.Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1292126550204379668, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126549885612561, language=CN, stringName=李巧艳, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=a, address=a.河南省人民医院 药学部,河南 郑州 450003, bio={"content":"

李巧艳(1985-),女,副主任药师,主要从事临床个体化用药相关的工作和研究

"}, bioImg=null, bioContent=

李巧艳(1985-),女,副主任药师,主要从事临床个体化用药相关的工作和研究

, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1292126549524902410, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, xref=a., ext=[AuthorCompanyExt(id=1292126549533291019, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549524902410, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China), AuthorCompanyExt(id=1292126549545873932, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549524902410, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.河南省人民医院 药学部,河南 郑州 450003)])]), Author(id=1292126550279877142, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, orderNo=1, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1292126550367957528, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126550279877142, language=EN, stringName=Ai-ling MA, firstName=Ai-ling, middleName=null, lastName=MA, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=a, address=a.Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1292126552062456345, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126550279877142, language=CN, stringName=马爱玲, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=a, address=a.河南省人民医院 药学部,河南 郑州 450003, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1292126549524902410, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, xref=a., ext=[AuthorCompanyExt(id=1292126549533291019, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549524902410, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China), AuthorCompanyExt(id=1292126549545873932, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549524902410, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.河南省人民医院 药学部,河南 郑州 450003)])]), Author(id=1292126552150536731, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, orderNo=2, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1292126552284754461, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126552150536731, language=EN, stringName=Yi-meng WANG, firstName=Yi-meng, middleName=null, lastName=WANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=a, address=a.Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1292126552351863326, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126552150536731, language=CN, stringName=王漪檬, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=a, address=a.河南省人民医院 药学部,河南 郑州 450003, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1292126549524902410, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, xref=a., ext=[AuthorCompanyExt(id=1292126549533291019, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549524902410, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China), AuthorCompanyExt(id=1292126549545873932, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549524902410, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.河南省人民医院 药学部,河南 郑州 450003)])]), Author(id=1292126552427360800, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, orderNo=3, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1292126552511246882, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126552427360800, language=EN, stringName=Dan YANG, firstName=Dan, middleName=null, lastName=YANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=a, address=a.Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1292126552595132963, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126552427360800, language=CN, stringName=杨丹, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=a, address=a.河南省人民医院 药学部,河南 郑州 450003, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1292126549524902410, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, xref=a., ext=[AuthorCompanyExt(id=1292126549533291019, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549524902410, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China), AuthorCompanyExt(id=1292126549545873932, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549524902410, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=a.河南省人民医院 药学部,河南 郑州 450003)])]), Author(id=1292126552758710821, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, orderNo=4, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=snowdrop999@163.com, emailSecond=null, emailThird=null, correspondingAuthor=1, authorType=1, ext={EN=AuthorExt(id=1292126552842596903, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126552758710821, language=EN, stringName=Xiang-li CHEN, firstName=Xiang-li, middleName=null, lastName=CHEN, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=b, address=b.Department of Hematology, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1292126552913900072, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, authorId=1292126552758710821, language=CN, stringName=陈香丽, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=b, address=b.河南省人民医院 血液内科,河南 郑州 450003, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1292126549801726477, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, xref=b., ext=[AuthorCompanyExt(id=1292126549810115086, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549801726477, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=b.Department of Hematology, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China), AuthorCompanyExt(id=1292126549818503695, tenantId=1146029695717560320, journalId=1246415772164075586, articleId=1292126548690235911, companyId=1292126549801726477, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=b.河南省人民医院 血液内科,河南 郑州 450003)])])]
李巧艳a, 马爱玲a, 王漪檬a, 杨丹a, 陈香丽b
作者信息
  • a.河南省人民医院 药学部,河南 郑州 450003
  • b.河南省人民医院 血液内科,河南 郑州 450003
通讯作者:
陈香丽,主任医师,硕士生导师 Tel: (0371)65897521 E-mail:
作者简介:

李巧艳(1985-),女,副主任药师,主要从事临床个体化用药相关的工作和研究

Clinical study on severe delayed excretion complicated with acute kidney injury in hematological malignancies treated with high-dose methotrexate
Qiao-yan LIa, Ai-ling MAa, Yi-meng WANGa, Dan YANGa, Xiang-li CHENb
Affiliations
  • a.Department of Pharmacy, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
  • b.Department of Hematology, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
出版时间: 2026-02-17 doi: 10.13699/j.cnki.1001-6821.2026.03.006
文章导航
收藏切换
目的

观察血液系统恶性肿瘤患者使用大剂量甲氨蝶呤(HD-MTX)化疗方案发生重度排泄延迟时,急性肾损伤(AKI)的发生情况与风险因素,并探讨此类患者发生药物不良反应后再次使用HD-MTX方案时的剂量调整策略。

方法

以本院血液内科和肿瘤内科就诊的、使用HD-MTX化疗方案的血液系统恶性肿瘤患者为研究对象,筛选发生重度排泄延迟(MTX滴注结束24 h时,血药浓度大于30 μmol·L-1,或48 h时,血药浓度大于3 μmol·L-1,或72 h时,血药浓度大于0.3 μmol·L-1,或谷浓度>0.3 μmol·L-1持续时间大于6天)的患者,根据患者用药后相关临床指标以及治疗方案将患者分为3组,A组为轻度AKI组;B组为中度AKI组;C组为重度AKI组,应用统计学方法分析患者发生排泄重度延迟以及AKI的风险因素。

结果

本研究入组的26例患者在28个HD-MTX治疗周期中均发生了甲氨蝶呤重度排泄延迟,此28个周期均出现了不同程度的AKI(100.00%),A组占21.43%(6个/28个);B组占46.43%(13个/28个);C组占32.14%(9个/28个)。给药前,A组、B组和C组的白蛋白水平分别为(42.22±4.63),(39.08±4.26)和(35.25±4.19)g·L-1,A组与C组比较,在统计学上差异有统计学意义(P<0.05)。经统计学分析发现,患者使用HD-MTX方案前的白蛋白水平与肾损伤程度在统计学上有显著相关性,白蛋白水平越低的患者发生发生中重度肾损伤的风险越高。发生中重度AKI的患者在后续治疗中有11位患者接受了19个周期的HD-MTX方案,甲氨蝶呤剂量在原剂量的1/3~1倍内波动,均未再发生排泄延迟以及AKI。

结论

恶性血液系统肿瘤患者使用大剂量甲氨蝶呤化疗方案时,用药前白蛋白水平与患者发生肾损伤的风险密切相关,白蛋白水平越低肾损伤程度越高。有MTX相关的中重度肾损伤病史的患者,在肾功能恢复后,可以根据患者临床指标降低剂量或维持原剂量继续使用HD-MTX方案,并不会发生AKI。

大剂量甲氨蝶呤  /  白蛋白水平  /  肾损伤  /  剂量调整
Objective

To analyze the occurrence and risk factors of acute kidney injury (AKI) in patients with hematologic malignancies who experienced severe delayed excretion after high-dose methotrexate (HD-MTX) chemotherapy, and to explore dose adjustment strategies for reusing HD-MTX in these patients.

Methods

A retrospective analysis was conducted on clinical data of hematologic malignancy patients treated with HD-MTX in the hematology and oncology departments. Patients with severe delayed MTX excretion (defined as serum MTX >30 μmol·L-1 at 24 h, >3 μmol·L-1 at 48 h, >0.3 μmol·L-1 at 72 h, or prolonged low-level MTX >0.3 μmol·L-1 for >6 days) were included. Patients were divided into three groups based on AKI severity, group A was mild AKI, group B was moderate AKT, group C was severe AKI. Statistical methods were used to analyze risk factors for severe excretion delay and AKI.

Results

Among 26 patients (28 HD-MTX cycles) with severe delayed excretion, AKI occurred in all cycles (100.00%). Group A accounted for 21.43% (6 cases/28 cases), Group B accounted for 46.43% (13 cases/28 cases), accounted for 32.14% (9 cases/28 cases). Pre-treatment albumin levels in group A, group B and group C were (42.22±4.63), (39.08±4.3) and (35.25±4.19) g·L-1. Among patients with moderate/severe AKI, 11 received 19 subsequent HD-MTX cycles at reduced doses (1/3-1× original), with no recurrence of excretion delay or AKI.

Conclusion

Low pre-treatment albumin levels, particularly <35 g·L-1 are strongly associated with severe MTX-related AKI. Patients with a history of MTX-induced AKI can safely reuse HD-MTX at adjusted doses (based on renal recovery and clinical indicators) without AKI recurrence.

high-dose methotrexate  /  albumin level  /  kidney injury  /  dose adjustment
李巧艳, 马爱玲, 王漪檬, 杨丹, 陈香丽. 大剂量甲氨蝶呤治疗恶性血液系统肿瘤中排泄重度延迟并发急性肾损伤的临床研究. 中国临床药理学杂志, 2026 , 42 (3) : 333 -337 . DOI: 10.13699/j.cnki.1001-6821.2026.03.006
Qiao-yan LI, Ai-ling MA, Yi-meng WANG, Dan YANG, Xiang-li CHEN. Clinical study on severe delayed excretion complicated with acute kidney injury in hematological malignancies treated with high-dose methotrexate[J]. Chinese Journal of Clinical Pharmacology, 2026 , 42 (3) : 333 -337 . DOI: 10.13699/j.cnki.1001-6821.2026.03.006

参考文献 引证文献
排序方式:
2026年第42卷第3期
PDF下载
117
23
引用本文
BibTeX
文章信息
doi: 10.13699/j.cnki.1001-6821.2026.03.006
  • 接收时间:2025-05-13
  • 首发时间:2026-08-06
  • 出版时间:2026-02-17
补充材料
相关文章
文章信息
作者
出版历史
  • 收稿日期:2025-05-13
基金
作者信息
    a.河南省人民医院 药学部,河南 郑州 450003
    b.河南省人民医院 血液内科,河南 郑州 450003

通讯作者:

陈香丽,主任医师,硕士生导师 Tel: (0371)65897521 E-mail:
参考文献
分享链接
https://castjournals.cast.org.cn/joweb/zglcylxzz/CN/10.13699/j.cnki.1001-6821.2026.03.006
分享至
全文二维码

扫描看全文

引用本文
BibTeX
本文的引用情况
2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
关闭全屏