简短报告：急性淋巴细胞白血病诊断一年后静脉注射甲氨蝶呤剂量和输注速率对神经心理功能的影响
Brief report: effect of intravenous methotrexate dose and infusion rate on neuropsychological function one year after diagnosis of acute lymphoblastic leukemia.
作者信息
Carey Marissa E, Hockenberry Marilyn J, Moore Ida M, Hutter John J, Krull Kevin R, Pasvogel Alice, Kaemingk Kris L
机构信息
West Virginia University, Department of Behavioral Medicine and Psychiatry, 930 Chestnut Ridge Road, PO Box 9137, Morgantown, West Virginia 26505, USA.
出版信息
J Pediatr Psychol. 2007 Mar;32(2):189-93. doi: 10.1093/jpepsy/jsj114. Epub 2006 May 4.
OBJECTIVE
To compare the effects of two intravenous (IV) methotrexate (MTX) infusion protocols on cognitive function in children newly diagnosed with acute lymphoblastic leukemia (ALL).
METHODS
We compared 19 children treated with 1 g/m(2) of IV MTX over 24 hr (Group 1) to 13 children treated with 2 g/m(2) of IV MTX over 4 hr (Group 2) on measures of working memory, nonverbal, and verbal skills shortly after diagnosis (Time 1) and 1 year later (Time 2).
RESULTS
A significant GroupxTime interaction was found for a composite measure of working memory with Group 2 declining from Time 1 to Time 2. Group 2 performed significantly worse than Group 1 on a composite measure of nonverbal skills at both time points.
CONCLUSIONS
Findings suggest that difficulties in working memory and nonverbal skills may be evident during the first year of treatment for ALL and that severity may be dependent on IV MTX dose and/or infusion rate.
目的
比较两种静脉注射甲氨蝶呤（MTX）输注方案对新诊断的急性淋巴细胞白血病（ALL）患儿认知功能的影响。
方法
我们将19名接受24小时静脉注射1 g/m² MTX治疗的儿童（第1组）与13名接受4小时静脉注射2 g/m² MTX治疗的儿童（第2组）在诊断后不久（时间1）和1年后（时间2）进行工作记忆、非语言和语言技能测量方面进行比较。
结果
在工作记忆综合测量中发现了显著的组×时间交互作用，第2组从时间1到时间2有所下降。在两个时间点，第2组在非语言技能综合测量上的表现均显著低于第1组。
结论
研究结果表明，在ALL治疗的第一年，工作记忆和非语言技能方面的困难可能很明显，且严重程度可能取决于静脉注射MTX的剂量和/或输注速度。
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