【摘要】 目的　探讨顺铂 (DDP)持续腹腔冲洗化疗 (CWIP)的药代动力学并观察其毒性作用。方法　对 2 5例初治的卵巢癌患者随机分为持续冲洗治疗组 (CWIP组 ) (10例 )和常规腹腔化疗组 (RIP组 ) (15例 )。CWIP组给予DDP 70mg/m2 ,常规腹化后开始DDP 17 5mg/m2 +NS 5 0 0ml持续冲洗化疗 ,治疗总时间为 12h ;RIP组为一次性灌注DDP 70mg/m2 +NS2 0 0 0ml。于用药后 72h内取血清、腹水及尿进行电化学极谱分析 ,测定铂 (Pt)浓度 ;并于化疗前、化疗后 3日、1月进行肝、肾、血常规及尿 β2 MG检测。结果　血清中总铂浓度峰值 (Cmax)在CWIP、RIP分别为 3 84μg/ml和 1 2 7μg/ml;腹水中Cmax分别为 7 0 4μg/ml和 4 43μg/ml。血清浓度 时间曲线下面积 (AUC)在CWIP和RIP分别为 10 6 7 77[(μg/ml) /h]和 191 72 [(μg/ml/h],腹水中AUC分别为 12 99 0 2 [(μg/ml) ]和 84 43[(μg/ml) /h],均具有显著差异 (P <0 0 5 )。尿铂的排泄在RIP组和CWIP组 2 4h内最多 ,分别为 46 15 %和48 2 4%。两组的毒副反应无显著差异。结论　持续腹腔冲洗化疗与常规腹腔化疗方法相比 ,可保持腹腔内、血清内DDP较长时间的高浓度 ,而其毒性作用并未增加。更多还原

【Abstract】 Objective To study on the pharmacokinetics of continuous washing of cisplatin (CWIP) in treating advanced ovarian cancers.Methods 25 cases were divided at raudom into CWIP group (10 case) and routine intraperitoneal chemotherapy group (RIP) 15 cases. In the CWIP group, 70 mg/m 2 of DDP in 2000 ml of NS was first used intraperitonealy on the 4th or 5th postoperative day and then followed by 17.5 mg/m 2 in 500 ml of NS as continuous dripping into the peritoneal cavity for 12 hours. While in the RIP group one dose of DDP 70 mg/m 2 in 2000 ml of NS was used.The blood serum, ascitic fluid and urine were collected and their platinum density was determined by electrochemical polarographic analysis. On the 3rd day and 1 month after treatment, the liver and kidney functions, blood routine, β 2 microglobulin in urine were examined. Results The maximum plasma concentration of platinum (C max ) in CWIP and RIP were 3.84 μg/ml and 1.27 μg/ml respectively; the C max of ascites were 7.04 μg/ml and 4.43 μg/ml in the 2 groups respectively. The area under the plasma concentration time curve (AUC) in CWIP and RIP were 1067.77 μg/ml/h and 191.72 μg/ml/h respectively, and those of AUC were 1299.02 μg/ml/h and 584.43 μg/ml/h respectively. These results in 2 groups showed significant difference ( P <0 05). The total cisplatin excretion was highest in urine in both groups. The side effects showed no marked difference in 2 groups. Conclusion CWIP is better than the RIP not only in the pharmacokinetics, but also in side effects.$$$$更多还原