Petrazzuoli M, Rothe M J, Grin-Jorgensen C, Ramsey W H, Grant-Kels J M
Department of Medicine, University of Connecticut School of Medicine, Farmington.
J Am Acad Dermatol. 1994 Dec;31(6):969-77. doi: 10.1016/s0190-9622(94)70266-7.
Controversy persists regarding the validity of published guidelines for the monitoring of methotrexate-induced hepatotoxicity.
The purpose of our study was to assess the standard of care by gastroenterologists in the monitoring of methotrexate-induced hepatotoxicity and to compare this standard of care with guidelines in the medical literature.
Gastroenterologists in Connecticut and Massachusetts were surveyed by a mail-in questionnaire that inquired about their protocol for the monitoring of hepatotoxicity in patients taking methotrexate.
Gastroenterologists in Connecticut and Massachusetts generally follow the guidelines in the medical literature. Variation in recommendations from the rheumatologic and the dermatologic literature is reflected in the practice habits of gastroenterologists whose patients are restricted to one particular population.
Long-term follow-up studies should be continued to obtain further data from which to make future recommendations, especially with regard to the effects of large cumulative doses of methotrexate.
关于已发表的甲氨蝶呤诱导肝毒性监测指南的有效性，争议仍然存在。
我们研究的目的是评估胃肠病学家在监测甲氨蝶呤诱导肝毒性方面的医疗标准，并将该医疗标准与医学文献中的指南进行比较。
通过邮寄问卷对康涅狄格州和马萨诸塞州的胃肠病学家进行调查，询问他们监测服用甲氨蝶呤患者肝毒性的方案。
康涅狄格州和马萨诸塞州的胃肠病学家通常遵循医学文献中的指南。风湿病学和皮肤病学文献中建议的差异反映在其患者仅限于特定人群的胃肠病学家的实践习惯中。
应继续进行长期随访研究，以获取更多数据，以便未来提出建议，特别是关于大剂量累积甲氨蝶呤的影响。
