肝静脉阻断下给药对门脉血药浓度的影响  

Influence of occlusion of hepatic vein on drug concentration in portal vein during drug administration

作　　者：沈玉英[1] 丁乙[2] 刘一之[2] 倪才方[2] 金咏梅[2] 朱晓黎[2] 

机构地区：[1]苏州市第四人民医院放射科,215006 [2]苏州大学附属第一医院影像中心

出　　处：《介入放射学杂志》2004年第4期351-353,共3页Journal of Interventional Radiology

摘　　要：目的　研究暂时性肝静脉 (HV)阻断下经肠系膜上动脉 (SMA)化疗及肝动脉 (HA)化疗的价值。方法　 10条犬 ,每犬均行 4组实验并作自身对照。于灌注 5 氟尿嘧啶 (5 Fu)以后 0 .5、5、10、15、2 0、30、6 0min抽取门脉血各 5ml,测定血药浓度 ,进行药动学分析。结果　阻断组 5 Fu的峰浓度及药时曲线下的面积明显高于单纯组 ,药物总清除率阻断组低于单纯组。肝静脉阻断下肝动脉造影显示阻断区末梢分支增多 ,肝段浓染明显。结论　暂时性阻断肝静脉经肠系膜上动脉、肝动脉灌注 5 Fu ,可以提高门脉及局部肝组织的药物浓度 ,延长药物作用时间 ,增强抗肿瘤作用。Objective To evaluate the value of transcatheter chemotherapy through superior mesenteric artery (SMA) and hepatic artery (HA) when hepatic vein (HV) was temporally occluded.Methods Altogether ten dogs, each of them was undengone four groups of experiments (A、B、C、D) respectively and subjected under self-control. A: transcatheter infusion of 5-Fu by SMA with HV occlusion (SMAI-THVO). B:only transcatheter infusion of 5-Fu throguh SMA(SMAI). C: infusion of 5-Fu through HA with HV occlusion (TAI-THVO). D: only infusion of 5-Fu through HA(TAI). 5 ml PV blood, withdrawn each once at 0.5, 5, 10, 15, 20, 30 min. after infusion of drug for each group respectively , was taken for analysis. The high performance liquid chromatograph (HPLC) was used to measure the blood concentration of 5-Fu in PV for pharmacokinetics, and the post-occlusion angiographic changes were analyzed. Results The peak concentration (cm) of 5-Fu of occlusion groups (A and C) and the area under the curve (AUC) of 5-Fu were greater than those in control groups (B and D), A>B>C>D(P<0.05). The total value of clearance in occlusion groups (A and C) was lower than that of the control groups (B and C), A<B<C<D(P<0.01). Hepatic arterial angiography showed more arterial branches and dense shadows of the corresponding hepatic segments with hepatic venous occlusion. Conclusion SMAI-THVO and TAI-THVO can markedly increase the blood concentration of 5-Fu in hepatic tissue and portal vein serving as a dual-route therapy with prolongation of anti-cancer effect.

关 键 词：阻断 肝静脉 门脉 血药浓度 5-Fu 肠系膜上动脉 药对 给药 暂时性 峰浓度 

分 类 号：R735.7[医药卫生—肿瘤]