壳多糖对骨巨细胞瘤的治疗意义

The significance of chitosan in treatment of giant cell tumor of bone

目的：确定壳多糖（几丁糖）是否可作为骨巨细胞瘤治疗的药物载体。方法：用壳多糖及壳多糖联合阿霉素、顺氨氯铂及甲氨蝶呤对骨巨细胞瘤进行体外敏感实验（ＭＴＴ法）。结果：单纯壳多糖对骨巨细胞瘤在体外无抑制作用（抑制率为１．８％），壳多糖联合阿霉素、顺氨氯铂及甲氨蝶呤分别较单独应用相同浓度（血浆峰值浓度）药物的抑制率要高，但无显著差异（Ｐ＞０．０５）。结论：壳多糖可以作为阿霉素、顺氨氯铂及甲氨蝶呤的良好缓释载体。由于骨巨细胞瘤要求化疗药物浓度较高（阿霉素、顺氨氯铂及甲氨蝶呤的血浆峰值浓度的抑制率分别为１７．０６％，１５．８７％，７．０９％），不适合常规的静脉及局部给药。故壳多糖与敏感药物制成的缓释系统用于局部治疗可在降低术后复发率上起到较为积极的作用。

Objective: To determine whether chitosan can be used as a drug carrier in treatment of giant cell tumor of bone (GCT). Methods: In vitro chemosensitivities of chitosan and chitosan with adriamycin(ADM),cisplachitin (CDDP), and methotrexate(MTX) to GCT were tested by using MTT method. Results:The only chitosan was had no inhibitory effect on GCT (inhibitory rate:1.8%),the inhibitory rates of chitosan with ADM,CDDP and MTX were higher than that of chitosan with ADM,CDDP and MTX in equal concentration (maximum concentration in plasma),but there were no marked differences (P>0.05). Conclusion:Chitosan can be used as a good sustained release carrier of ADM,CDDP and MTX.As the chemotherapeutic concentration of GCT is high (the inhibitory rates of ADM,CDDP,MTX in maximum concentration in plasma were 17.06%,15.87%,7.09%),usual injection in vein or local giving is not suited,and so it may be useful for sensitivity chemical drugloaded chitosan drug delivery system used for local treatment of GCT to reduce the recurrent rate after operation.