APA-BCC微胶囊蛛网膜下植入对癌痛病人的镇痛效应

THE ANALGESIC EFFECT OF APA-BCC TRANSPLANTED INTO SPINAL SUBARACHNOID SPACE ON CANCER PAIN

目的:观察脊髓蛛网膜下腔植入APA-BCC镇痛微胶囊对癌痛病人的镇痛效应及不良反应.方法 :将不同剂量的海藻酸钙-聚赖氨酸-海藻酸钙微胶囊包裹的牛肾上腺嗜铬细胞(APA-BCC微胶囊)按常规腰穿的方法注入100例中、重度癌痛患者的腰段脊髓蛛网膜下腔内.按数字分级法(NRS)评定疼痛程度的变化并记录止痛药使用情况;按WHO分级法评价不良反应;按孙燕等指标评价生活质量.结果: (1)APA-BCC注射后0.5～5天,在停用、减量和/或降级使用其它镇痛药的情况下,其镇痛的有效率(CR+PR)为84%、总有效率(CR+PR+MR)为96%,镇痛程度显著优于药物组.(2)1至2次使用后镇痛持续时间为9～220天,明显长于现有镇痛药.(3)APA-BCC治疗后,癌痛病人的生活质量及满意度显著提高.(4)APA-BCC注射后,除部分病人出现与常规蛛网膜下腔注射相近的轻度不良反应外,未观察到严重不良反应,患者的心率、血压、呼吸、肝肾功能、外周血象和免疫功能无明显变化.但单次使用1.5剂量时,2例患者出现了难以耐受的下肢震颤和背部沉重压迫感等重度不良反应.结论: APA-BCC微胶囊植入脑脊液内对癌痛病人具有明确的长效镇痛作用.

Objective ： To observe the analgesic effect and adverse effects of APA-BCC when transplanted into spinal subarachnoid of cancer pain patients. Methods ： Different doses of Alginate-Polylysine-Alginate microencapsulated bovine chromaffin cells （APA-BCC） were implanted into the spinal subarachnoid of 100 cancer pain patients ; changes of pain intensity, analgesic consumption, adverse-effects and life quality were evaluated. Results ： （ 1 ） The effective rate （ CR ＋ PR） and the total effective rate （ CR ＋ PR ＋ MR） were 84% and 96% within 5 days after transplantation. （2）The analgesia period varied between 9d and 220d. （3） The life quality and satisfaction degree were improved after APA-BCC transplantation. （4） There were no severe adverse effects observed. Conclusion： Transplantation of APA-BCC into spinal subarachnoid has long-term analgesic effect on cancer pain.