Leeb B, Dunky A, Ogris E, Wohanka A, Schenk G, Fischer M, Tausch G, Eberl R
II. Medizinischen Abteilung, Zentrum für Diagnostik und Therapie rheumatischer Erkrankungen, Krankenhauses der Stadt Wien-Lainz.
Acta Med Austriaca. 1988;15(5):140-4.
To verify the possibility of a concomitant therapy control in 31 patients (18 psoriatic arthritis [PA], 13 rheumatoid arthritis [RA]) the blood cell concentration of Methotrexate (MTX) was continuously measured over a period of 6 months. The determinations were carried out by using a RIA of the CIS Corp. At any time MTX was determined laboratory and clinical examinations were done and the P-III-P serum-level was measured by using a RIA of the Behringwerke. The cellular MTX showed to be statistically significantly elevated compared to baseline, whereas within ranges of total cumulative dosages only insignificant fluctuations could be noticed. Like in the treatment of Psoriasis a strict correlation between the weekly administered dose and the cellular MTX could be established, the total cumulative dose, however, had no influence on the cellular MTX-level. In the treatment of RA slightly higher weekly dosages were necessary, which caused significantly higher cellular MTX concentrations in RA patients. Some correlations between clinical as well as serological parameters of disease activity could be noticed, nevertheless they do not allow distinct interpretations. In both diseases a significant relationship between the cellular MTX-level and the P-III-P serum-level could be realized. A storage of MTX in blood cells, especially in erythrocytes, seems to be evident. To reach therapeutical benefit in RA slightly higher mean dosages may be necessary. A therapy monitoring by the means of continuous determinations of cellular MTX seems to be impossible. In contrast an approach to the early detection of liver fibrosis can be given by the correlation between cellular MTX and the P-III-P serum levels.
为验证对31例患者（18例银屑病关节炎[PA]，13例类风湿关节炎[RA]）进行联合治疗控制的可能性，在6个月的时间内持续测量甲氨蝶呤（MTX）的血细胞浓度。测定采用CIS公司的放射免疫分析法（RIA）。在任何时间测定MTX，同时进行实验室检查和临床检查，并采用贝林werke公司的RIA法测定血清Ⅲ型前胶原（P-III-P）水平。与基线相比，细胞内MTX在统计学上显著升高，而在总累积剂量范围内仅观察到微小波动。与银屑病治疗一样，每周给药剂量与细胞内MTX之间可建立严格的相关性，但总累积剂量对细胞内MTX水平无影响。在类风湿关节炎治疗中，每周需要稍高的剂量，这导致类风湿关节炎患者细胞内MTX浓度显著升高。可注意到疾病活动的临床及血清学参数之间存在一些相关性，但无法进行明确解释。在两种疾病中，细胞内MTX水平与P-III-P血清水平之间均存在显著关系。MTX似乎明显储存在血细胞中，尤其是红细胞中。为在类风湿关节炎中获得治疗益处，可能需要稍高的平均剂量。通过持续测定细胞内MTX进行治疗监测似乎不太可行。相比之下，细胞内MTX与P-III-P血清水平之间的相关性可为肝纤维化的早期检测提供一种方法。
