云克与^(153)钐-乙二胺四甲基膦酸对骨转移癌患者骨痛及疼痛因子的影响  

Alteration of pain related factors levels after Yunke and ^(153)Sm-EDTMP treatment in patients with painful skeletal metastases

作　　者：程光华[1] 戴云海[1] 杨军[1] 

机构地区：[1]皖南医学院弋矶山医院核医学科

出　　处：《中国临床药理学与治疗学》2006年第10期1140-1143,共4页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：安徽省教育厅科研计划项目(№2002jk318)

摘　　要：目的探讨云克(^(99)锝-亚甲基二膦酸盐注射液,^(99)Tc-MDP)与^(153)钐-乙二胺四甲基膦酸(^(153)Sm-EDT-MP)对多发性骨转移癌患者骨痛反应与体内疼痛因子的变化的关系。方法对93例多发性骨转移癌患者用云克与^(153)Sm-EDTMP治疗。其中单独^(153)Sm-EDT-MP治疗组55例,单独云克治疗组及云克与^(153)Sm-EDTMP联合治疗组各19例。分别对其治疗前与治疗后(3个月后)血浆内皮素(ET)、降钙素基因相关肽(CGRP)、血栓素B2(TXB2)与6-酮-前列环素F1α(6-k-PGF1α)含量变化进行了测定。结果治疗后三组患者骨痛缓解率分别为69.1%(38/55)、73.7%(14/19)及89.5%(17/19)。三组中,血浆ET与6-k-PGF1α含量治疗3月后均显著高于治疗前(P<0.01)。血浆CGRP与TXB2含量治疗后与治疗前相比,153Sm-EDTMP治疗组差异无统计学意义(P>0.05)。云克治疗组及联合治疗组两组TXB2含量治疗后与治疗前相比,差异无统计学意义(P>0.05);而CGRP则显著降低(P<0.05)。结论云克与153Sm-EDTMP联合治疗骨转移癌明显优于单独云克与单独153Sm-EDTMP治疗;治疗后骨痛反应与疼痛因子ET、6-k-PGF1α及CGRP含量变化有关。ABSTRACT AIM： To comparatively analyze the pain related factors levels and therapeutic response in patients treated with ^99 Tc-MDP and ^153Sm-EDTMP for painful skeletal metastases. METHODS： Plasma endothelin （ET）, calcitonin gene-related peptide （CGRP）, thromboxane B2 （TXB2） and 6-keto-prostaglandin F1α （6-k- PGF1α） levels were analyzed in 93 patients with painful skeletal metastases prior and 3 months after treatment. 55 cases were just treated with ^153Sm-EDTMP （ group A） ; 19 cases were treated only with ^99 Tc-MDP （group B）; and 19 cases were treated with both is3 Sm-EDTMP and ^99Tc-MDP （group C）. RESULTS： 69.1%, 73.7% and 89.5% of the patients were experienced pain relief 3 months after treatment in groups A, B and C, respectively. Comparative analysis shows that： ET and 6-k-PGF1α levels increased significantly 3 months after treatment in all patients （P 〈 0.01 ）; CGRP levels decreased significantly 3 months after treatment （ P 〈 0.05） in patients of groups B and C. No significant changes of CGRP and TXB2 levels were observed prior and after treatment in group A, nor do TXB2 levels in patients of groups B and C. CONCLUSION： Combined treatment with ^99Tc-MDP and ^153Sm-EDTMP were found more efficient in patients with skeletal metastases than just treatment with ^153Sm- EDTMP. The therapeutic response of ^99Tc-MDP and ^153Sm-EDTMP for painful skeletal metastases may be closely related to the alteration of plasma ET, 6-k-PGF1α and CGRP levels.

关 键 词：云克 ^153钐-乙二胺四甲基膦酸 骨转移癌 内皮素 降钙素基因相关肽 血栓素B2  6-酮-前列环素F1Α 

分 类 号：R965.2[医药卫生—药理学]