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甲氨蝶呤常用于治疗癌症和炎症(如风湿性关节炎)。甲氨蝶呤通过抑制叶酸还原,能够破坏DNA合成,从而抑制细胞增殖。然而,临床研究发现甲氨蝶呤除了有抑制细胞增殖作用外,还有直接的细胞毒作用。这些报道主要描述了该药物的中枢神经系统毒性,并提示对代谢通路的干扰可能是产生这一毒性的原因。本文主要描述了一位年轻的骨肉瘤患者在高剂量滴注甲氨蝶呤治疗过程中引发心律失常的案例。从以往健康成人使用甲氨蝶呤的病例中,临床医生应该意识到给病人使用高剂量甲氨蝶呤会引发心脏病症状和心律失常等并发症,同时也应该提高警惕和进行更多的临床调查。
Methotrexate is commonly used to treat cancer and inflammation (such as rheumatoid arthritis). Methotrexate can inhibit DNA synthesis by inhibiting folic acid reduction, thereby inhibiting cell proliferation. However, clinical studies have found that methotrexate in addition to inhibiting cell proliferation, but also direct cytotoxicity. These reports mainly describe the CNS toxicity of the drug and suggest that interference with metabolic pathways may be responsible for this toxicity. This article describes a case of a young osteosarcoma patient initiating an arrhythmia during high-dose instillation of methotrexate. From previous cases of methotrexate in healthy adults, clinicians should be aware that the use of high-dose methotrexate in patients can lead to complications such as heart disease symptoms and arrhythmias, as well as increased vigilance and more clinical survey.