隔离盆腔化疗联合血液灌流的方法学实验研究

Methodological experimental study on isolated pelvic cavity chemotherapy combined with hemoperfusion

目的探讨隔离盆腔化疗联合血液灌流的可行性及药代动力学变化。方法将10只犬随机分为2组,对照组4只,行常规髂内动脉灌注化疗;实验组6只,利用介入放射学行经皮盆腔封闭式循环化疗结合血液灌流。化疗药物选用5-氟尿嘧啶。分别定时检测两组髂内静脉、外周血液的血药浓度;并检测实验组血液灌流后的血药浓度。结果对照组和实验组髂内静脉血血药浓度均在10min达到峰值,分别为(3698.32±371.71)、(3577.52±366.28)ng/mL,两组比较无显著差异(P>0.05)。但对照组20、30、40、50和60min血药浓度迅速下降,分别为(2450.51±233.80)、(1867.30±181.40)、(1256.96±125.70)、(673.36±65.60)、(543.32±53.90)ng/mL,而实验组仍保持较高浓度,分别为(3489.28±328.70)、(3341.09±316.40)、(2973.59±277.10)、(2744.11±255.40)和(2111.48±201.70)ng/mL,两组各时段血药浓度比较有显著差异(P<0.01)。两组AUC分别为(99418.68±946.90)、(168465.40±1577.13)ng/mm,有差异显著性(P<0.01)。各时段实验组均显著低于对照组(P<0.01)。对照组外周血10、20、30、40、50和60min血药浓度分别为(3564.73±343.40)、(2365.85±241.50)、(1397.22±129.70)、(1139.71±104.30)、(690.96±66.50)和(537.39±51.10)ng/mL,实验组分别为(18.86±1.70)、(25.90±2.30)、(37.11±3.50)、(70.23±7.40)、(94.86±8.60)和(127.54±13.10)ng/mL,两组差异有显著性(P<0.01)。实验组血液灌流后的血药清除率为(92.04±8.40)%。结论隔离盆腔化疗联合血液灌流是一种可行的技术,与常规髂内动脉灌注化疗相比,不仅增加局部血药浓度,而且可维持较长时间,更可以降低外周的血药浓度,减少毒副作用。

[ Objective ] To study the feasibility and medicine generation of dynamic changes of isolated pelvic cavity chemotherapy combined with hemoperfusion. [Methods] 10 dogs were divided into 2 groups stochastically, control group 4 dogs underwent the procedure of routine internal iliae arterial infusion chemotherapy; Experimental group 6 dogs received pelvic cavity isolated circulation chemotherapy by the skin used the way of interventional radiology and combined with hemoperfusion. The chemotherapy medicine selects 5- fluorine uracil. The blood medicine concentration in internal iliac vein and peripheral venous blood of two groups was measured, and the blood medicine concentration after hemoperfusion of experimental group. [ Results] The blood medicine concentration in internal iliac vein of the control group and the experimental group reaches the peak level in 10 minutes, respectively be （3698.32±371.71）, （3577.52±366.28） ng/mL, two groups compares the not significant difference （P 〉0.05）. But control group 20, 30, 40, 50 and 60 minutes blood medicine concentration rapid drop, respectively be （2450.51± 233.80）, （1867.30±181.40）, （1256.96±125.70）, （673.36±65.60）, （543.32±53.90） ng/mL, the experimental group still maintained the high level, respectively be （3489.28±328.70）, （3341.09±316.40）, （2973.59±277.10）, （2744.11± 255.40）, （2111.48±201.70） ng/mL, two group of every time intervals blood medicine concentration comparison had significant difference （P 〈0.01）, two group of AUC respectively be （99418.68±946.90）, （168465.40±1577.13） ng/mm, two groups of comparisons had the significant difference （P 〈0.01）. The peripheral venous blood medicine concentration of the control group 10, 20, 30,40, 50 and 60 minutes respectively was （3564.73±343.40）,（2365.85±241.50）, （1397.22±129.70）, （1139.71±104.30）, （690.96±66.50）, （537.39±51.10） ng/mL, experimental group respectively was （18.86±1.70）, （25.90±2.30）, （37.11±3.50）, （70.23±7.40）, （94.86＋8.60）, （127.54±13.10） ng/mL, two groups had the significant difference （P 〈0.01）. The clearance rate of the blood medicine of the experimental group after hemoperfusion was （92.04±8.40）%. [ Conclusion ] Isolated pelvic cavity chemotherapy combined with Hemoperfusion is one kind of feasible technology, compared with routine internal iliae arterial infusion chemotherapy, it not only may increase the partial blood medicine concentration, moreover may maintain the long time, may reduce the peripheral blood medicine concentration, reduces the poisonous side effect.