紫杉醇与照射同步使用致肺损伤的实验研究  

The experimental study of the accentuated irradiation pulmonary injuries by concurrent paclitaxel and irradiation

作　　者：赵路军[1] 冯勤付[1] 杨伟志[1] 张郁[1] 

机构地区：[1]中国医学科学院协和医科大学肿瘤医院放射治疗科,北京100021

出　　处：《临床肿瘤学杂志》2005年第5期449-454,共6页Chinese Clinical Oncology

基　　金：国家自然科学基金资助课题(项目号:30270344)

摘　　要：目的用小鼠肺损伤模型模拟临床治疗,进行紫杉醇(泰素)与照射同步使用致肺损伤的研究,对其损伤模式及其机理进行初步的探索。方法小鼠分正常对照(Control组)、单用紫杉醇(CT组)、单纯照射(RT组)、紫杉醇照射同步(CRT组)4个组,照射和用药的小鼠行全肺照射21Gy/5次/5天和周1与周4共2次腹腔注射紫杉醇30mg/kg,从实验后第1个月～第6个月观察肺泡灌洗液蛋白和细胞数变化、小鼠死亡、血性胸水、肺泡壁水肿和细胞浸润以及肺纤维化积分共6个指标的情况。结果在紫杉醇照射同步组因肺损伤死亡小鼠(19/54)比单纯照射组(10/54)明显增多(P<0.05),死亡时间和出现胸水均提前1个月;肺泡灌洗液内蛋白含量和细胞总数除第1个月外,均比单纯照射组高,在第4个月明显(P<0.01)。单纯紫杉醇组第1个月也比对照组高,而且肺泡壁肿胀与炎性细胞浸润明显,但无统计学差异。紫杉醇照射同步组的肺纤维化积分比单纯照射组明显,差别从第3个月后开始出现,而以第4个月明显,肺纤维化积分分别为5.6±0.7与3.8±0.7(P<0.05)。结论紫杉醇与照射同步使用能扩大肺组织的放射性损伤,单纯紫杉醇也可致肺组织损伤,但损伤相对较轻,与照射同用可使致死性损伤增加。Objective：To study the model and mechanism in accentuated acute and late pulmonary toxicity by concurrent irradiation and paclitaxel used the model of Irradiation pulmonary injuries in mice. Methods：Four groups-control ,paclitaxel alone（ CT alone） ,irradiation alone（ RT alone）,concurrent irradiation and paclitaxel（CRT） were entered the study. The mice with irradiation and paclitaxel were given 21Gy/5f/5d in whole lung and 30mg/kg twice a week. The mortality of mice, pleural infusion, protein and cell presence in bronchoalveolar lavage （BAL） and pulmonary fibrosis were carried on for every month, still to 6 months. Results：There were higher mortality of mice and earlier of 1 month in the groups of concurrent irradiation and paclitaxel than in radiation alone. A higher protein and cell presence in bronchoalveolar lavage（BAL） were seen in the groups with CRT compared with RT alone from 2-6 months, especially in 4 months. Similar differences were also measured during pulmonary fibrosis examination after 4 months radiation. The more septal swelling and septal cell and higher protein and presence cell in BAL were found in the paclitaxel alone group compared with control group. Conclusion ：The study show paclitaxel can accentuated radiation induced acute and late pulmonary injuries. Paclitaxel alone also induced pulmonary injuries. However, the injuries may be slight, but it is very important to accentuated pulmonary injury when radiation is given.

关 键 词：放射性肺损伤 化疗性肺损伤 紫杉醇 动物实验 

分 类 号：R730.53[医药卫生—肿瘤] R730.55[医药卫生—临床医学]