蛛网膜下植入微囊化牛肾上腺嗜铬细胞对癌痛患者脑啡肽含量及镇痛作用的影响

Effects of transplantation of APA microencapsulized bovine chromaffin cells into the arachnoid on the enkephalin concentration and analgesic mechanism of cancer pain patients

目的:了解海藻酸钠-多聚赖氨酸-海藻酸钠微囊化牛肾上腺嗜铬细胞(APA-BCC微胶囊)植入癌痛患者脊髓蛛网膜下产生镇痛的同时对脑脊液中内源性阿片肽类物质含量的影响。方法:将APA-BCC微胶囊注射入晚期癌症并伴有中、重度疼痛患者的腰段脊髓蛛网膜下腔内;分别采取移植前、移植后6～8d的脑脊液,部分患者又采取了移植后13～17d的脑脊液;用放射免疫法检测脑脊液中亮氨酸脑啡肽(L-EK)、β-内啡肽(β-EP)、强啡肽(DynA)的含量。结果:与移植前比较,移植后患者脑脊液中L-EK的含量明显升高,其中移植剂量为1.0×107时,升高最为显著;而移植后脑脊液中β-EP和DynA的含量无明显改变。结论:APA-BCC微胶囊植入对癌痛患者的镇痛效应可能与脑脊液中L-EK的含量升高有关。

AIM:To study the effect of APA BCC (alginate polylysine alginate microencapsulated bovine adrenal medullary chromaffin cells) microcapsule transplantation into the subarachnoid space of cancer pain patients on endogenetic enkephalin concentration in cerebrospinal fluid(CSF) when analgetic effects occurs. METHODS:APA BCC microcapsules were transplanted into the lumbar subarachnoid space of cancer patients with moderate or severe pain symptom;the CSF of patients was collected at different times: before transplantation,6-8 days after transplantation and 13-17 days after transplantation for some patients; the concentrations of L EK,β EP and DynA in CSF were detected by isotopes radiation immunoassay. RESULTS:L EK concentration in CSF increased remarkably after transplantation, and the increment was most remarkable when transplantation dosage was 1.0×107; there were no significant changes in β EP and DynA after transplantation. CONCLUSION:The analgetic effects of APA BCC microcapsule transplantation may correlate with the increase of L EK in CSF of cancer pain patients.