卡介苗膀胱灌注对膀胱癌患者血、尿内毒素水平的影响  

Study on endotoxins in urine and blood plasma during the intravesical BCG therapy

作　　者：任黎刚[1] 汪朔[2] 傅素珍[3] 肖家全[1] 邹强[1] 董志超[1] 

机构地区：[1]浙江省人民医院泌尿外科,浙江杭州310014 [2]浙江大学医学院附属第一医院泌尿外科 [3]浙江大学医学院附属第一医院传染病科人工肝实验室,浙江杭州310003

出　　处：《现代泌尿外科杂志》2005年第2期77-79,共3页Journal of Modern Urology

摘　　要：目的　探讨卡介苗(BCG)膀胱灌注治疗期间患者血浆、尿液内毒素水平的变化及其意义。方法　对 11 例初发的膀胱癌患者行BCG膀胱灌注,在6周疗程中的第1、3、5周的灌注前后采集血、尿标本,以偶氮显色法做内毒素浓度测定。采用 SPSS10.0非参数检验中的秩和检验行统计学处理。结果　膀胱灌注的第1周血浆内毒素水平在灌注前后分别为(27.54±18.69)ng/L和(45.62±30.77)ng/L(P=0.054);第3周为(48.23±29.53)ng/L和(77.08±40.96)ng/L(P<0.01);第 5 周为(49.00±42.10)ng/L和(80.69±59.20)ng/L(P<0.05)。6个组间血内毒素水平比较差异有显著意义(P<0.01);尿液内毒素水平前后差异无统计学意义。结论　BCG膀胱灌注可引起血浆内毒素水平升高,这可能与BCG不良反应发生有关。Objective To explore the occurrence and characteristic of endotoxins in urine and blood plasma of patients with bladder tumor during the intravesical BCG therapy. Methods Postoperative intravesical instillation of BCG for superficial bladder tumor were conducted in 11 cases who had initial treatment in our department between January 2001 and January 2002. Endotoxin was determined by the Limulus amebocyte lysate (LAL) assay. The clinical side effects during the course were observed. Results Before and after the first week of instillation, the concentrations in blood plasma were 27.54±18.69ng/L and 45.62±30.77ng/L (P= 0.054) , respectively; the third week, 48.23±29.53ng/L and 77.08±40.96ng/L(P<0.01); the fifth week, 49.00±42.10ng/L and 80.69±59.20ng/L (P<0.05). A statistically significant difference amongst these groups were observed by Friedman test. Endotoxin concentration in the urine did not change significantly. Conclusion The result suggested that BCG instillation could elevate the endotoxin concentration of plasma and might be responsible for side effects during intravesical BCG instillation.

关 键 词：膀胱灌注 血浆内毒素 患者 BCG 卡介苗 膀胱癌 尿液 水平 采集 变化 

分 类 号：R737.14[医药卫生—肿瘤] R186[医药卫生—临床医学]