Weinblatt M E, Fraser P
Department of Rheumatology and Immunology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.
Arthritis Rheum. 1989 Dec;32(12):1592-6. doi: 10.1002/anr.1780321214.
Retrospective analysis of 23 rheumatoid arthritis patients receiving low-dose methotrexate (MTX) demonstrated an association between the mean corpuscular volume (MCV) and hematologic toxicity. All 6 patients who developed hematologic toxicity were folate deficient, and 4 of 6 had marked macrocytosis. Furthermore, the mean MCV of the patients who developed toxicity was significantly higher than that of the controls without toxicity (P less than 0.02). This difference in MCV was associated with an increased probability of developing toxicity with time (P less than 0.005). These results suggest that sustained elevation in the MCV may be a predictor of impending hematologic toxicity due to folate depletion.
对23名接受低剂量甲氨蝶呤（MTX）治疗的类风湿性关节炎患者进行的回顾性分析表明，平均红细胞体积（MCV）与血液学毒性之间存在关联。所有6名发生血液学毒性的患者均缺乏叶酸，6名中有4名有明显的大细胞性贫血。此外，发生毒性反应的患者的平均MCV显著高于无毒性反应的对照组（P<0.02）。MCV的这种差异与随着时间推移发生毒性反应的可能性增加有关（P<0.005）。这些结果表明，MCV持续升高可能是叶酸缺乏导致即将发生血液学毒性的一个预测指标。
