【摘要】 目的　研究腹腔化疗的药代动力学特点 ,探讨肝动脉化疗栓塞术中联合腹腔序贯化疗的可行性 ,临床疗效及毒副反应。方法　实验用家兔腹腔内注入 5 Fu 10 0ms/kg ,分别于设定时间抽取门静脉 ,腹主动脉 ,外周静脉血 ,腹腔液 ,肝、肾组织标本采用高效液相色谱法测定药物浓度 ;选择中晚期失去手术机会的临床确诊原发性肝癌病人 60例 ,随机分组为实验组 (行肝动脉化疗栓塞术中联合腹腔序贯化疗 )和对照组 (单纯行肝动脉化疗栓塞术 )。每组各 3 0例。观察治疗前后白细胞、肝功能转氨酶、血清甲胎蛋白 (AFP)、肿瘤生长相关物质 (TSGF)含量、肿瘤大小 ,并比较前后变化。结果　腹腔给药后药物在腹腔液中的浓度最高 ,其峰值浓度是外周静脉血中药物浓度的 2 66.7倍 ,门静脉其次 ,约 11.3倍 ,腹主动脉 ,外周静脉血浓度相仿 ,为最低。肝组织中药物峰值浓度是肾组织的 10 .6倍。给药 2 40分钟后仍可见其组织中存在较高的药物浓度 ,递减缓慢 ,浓度恒定 ,维持时间长 ,门静脉中亦有相似趋势。实验组和对照组在肿瘤大小变化、血白细胞计数、肝功能转氨酶变化上介入治疗前后无显著性差异 ,(P >0 .0 5 )。血清甲胎蛋白 (AFP)及肿瘤生长相关物质 (TSGF)含量变化在介入治疗前后显著差异 ,(P <0 .0 5 )。结论　肝动脉化疗栓塞术?更多还原

【Abstract】 Objective To study pharmacokinetic characteristic of celiac chemotherapy and to investigate the clinical significance of sequential celiac chemotherapy in transcatheter arterial chemotherapeutic embolization (TACE).Methods A rabbit was celiac perfused with 5 Fu 100mg/kg.Then the drug concentrations in portal vein, abdominal aorta,peripheral venous blood,hydroperitonea and tissues of liver and kidney were assayed by liquid chromatography in special time.60 cases of hepatocellular carcinoma(HCC) were radomized into experimental group and control group.The count of WBC,liver function,serum A Fetoprotein(AFP),tumor specific growth factor (TSGF) and the size of cancer were evaluated before and after the treatment.Results The drug concentration in the abdominal cavity was the highest, portal vein was the second,and in abdominal aorta and peripheral venous was the lowest.The first was 266.7 times as much as that of the second,and the second was 11.3 times as much as that of the third.The highest drug concentraction in the tissue of liver was 10.6 times as much as that in the kindney.And the drug concentration in these two tissues was high for a long time after 240 minutes of administration.The size of tumor,the count of WBC and the liver function had no significant differences between the experimental group and control group (P>0.05).The serum AFP and TSGF after the interventional treatment were significant different from those before the treatment(P>0.05).Conclusion Sequential celiac chemotherapy in TACE is a safe method in treating HCC.TACE and sequential chemotherapy could inhibit the development of the cancer synergistically and the latter doesn′t induce toxic reaction.更多还原