放疗同步健择与顺铂化疗对大鼠脊髓损伤的实验研究  

Rats spinal cord injury caused by gemcitabine and cisplatin combined with synchronous radiotherapy

作　　者：邹丽娟[1] 王媛媛[2] 李国权[1] 吕广艳[3] 王若雨[4] 邵淑娟[5] 

机构地区：[1]大连医科大学附属第二医院肿瘤放疗科,辽宁大连116023 [2]阜新市中心医院放疗科,辽宁阜新123000 [3]大连医科大学分析测试中心,辽宁大连116023 [4]大连大学附属中山医院肿瘤科,辽宁大连116023 [5]大连医科大学组织与胚胎学教研室,辽宁大连116023

出　　处：《中华肿瘤防治杂志》2009年第3期179-181,189,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：辽宁省科技攻关资助项目(2005225003-12)

摘　　要：目的:探讨放射治疗同步顺铂(DDP)和健择(GEM)化疗对大鼠脊髓损伤的影响。方法:观察正常对照组、单纯放疗组、单纯化疗组(健择组、顺铂+健择组)与放疗联合化疗组(健择联合放疗组、顺铂+健择联合放疗组)的光镜和电镜下脊髓的形态学改变。结果:光镜下,单化组灰质出现白质部分脱髓鞘、变性、炎性细胞浸润,灰质结构疏松和血管增多,排列紊乱。单放组白质内神经纤维排列松散紊乱,部分白质出现细胞肿胀、坏死和炎细胞浸润,部分神经元尼氏体消失,神经胶质细胞固缩。化放组白质出现广泛脱髓鞘、炎细胞浸润、灰质血管增多和神经元固缩等改变。电镜下单化组脊髓髓鞘的髓板增厚、扭曲和皱缩;单放组髓鞘的板层结构松解、扭曲;化放组髓鞘轴索皱缩,髓鞘不规则分层且不规则增生,板层结构不明显。结论:不论健择单药还是健择和顺铂联合化疗均可引起大鼠脊髓损伤,放射治疗同步顺铂和健择化疗较单纯放疗加重对大鼠的脊髓损伤。OBJECTIVE： This study investigated the effects of radiotherapy combined synchronously with gemcitabine and cisplatin on the spinal cord of rats. METHODS： The morphological changes of control group, radiotherapeutic group, chemotherapeutic groups （GEM,GEM＋ eisplatin） and combined groups （GEM＋ radiotherapy, GEM＋eisplatin ＋radiotherapy） were observed with light and transmission electron microscopes. RESULTS： Under light microscopic level, in chemotherapeutic groups the white matter appeared demyelinating partly, denaturation and inflammatory cell infiltration; the gray matter showed loosen structrue, increased and disordered vessels. In radiotherapeutic group, nerve fibers in white matter were loosen and disordered; some white matter appeared swelling and necrotic cells and inflammatory cell infiltration. Some nissl bodies disappeared and glial cells were pyknotic. In combined groups, white matter appeared demyelination extensively and inflammatory cell infiltration, vessel in gray matter increased and neuron was pyknotic, etc. Under transmission electron microscopic level, in chemotherapeutic groups, neural plate in spinal cord myelin appeared thickened, twisted and shrinked. In radiotherapic group, slab structure in myelin was lossen and twisty. In combined groups, axonal in myelin was shrinked, myelin was delaminated and proliferated irregularly; slab struetrue became unobviously. CONCLUSION： Both GEM alone and cisplatin ＋ GEM can cause spinal cord injury in rats. Spinal cord injury induced by chemotherapy and radiotherapy combined synchronously was more serious than radiotherapy alone.

关 键 词：肿瘤/放射疗法 肿瘤/药物疗法 脊髓损伤 动物 对比研究 

分 类 号：R730.5[医药卫生—肿瘤]