【摘要】 目的探讨云克(⁹⁹锝-亚甲基二膦酸盐注射液,⁹⁹Tc-MDP)与¹⁵³钐-乙二胺四甲基膦酸(¹⁵³Sm-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¹⁵³Sm-EDTMP治疗。其中单独¹⁵³Sm-EDT-MP治疗组55例,单独云克治疗组及云克与¹⁵³Sm-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。更多还原

【Abstract】 AIM: To comparatively analyze the pain related factors levels and therapeutic response in patients treated with ⁹⁹Tc-MDP and ¹⁵³Sm-EDTMP for painful skeletal metastases. METHODS: Plasma endothelin （ET）, calcitonin gene-related peptide （CGRP）, thromboxane B₂ （TXB₂） and 6-keto-prostaglandin F 1α （6-k-PGF 1α ） levels were analyzed in 93 patients with painful skeletal metastases prior and 3 months after treatment. 55 cases were just treated with 153 Sm-EDTMP （group A）; 19 cases were treated only with 99 Tc-MDP （group B）; and 19 cases were treated with both 153 Sm-EDTMP and 99 Tc -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-PGF 1α 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 99 Tc-MDP and 153 Sm-EDTMP were found more efficient in patients with skeletal metastases than just treatment with 153 Sm-EDTMP. The therapeutic response of ⁹⁹Tc-MDP and 153 Sm- EDTMP for painful skeletal metastases may be closely related to the alteration of plasma ET, 6-k-PGF_1α and CGRP levels.更多还原