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目的:了解海藻酸钠-多聚赖氨酸-海藻酸钠微囊化牛肾上腺嗜铬细胞(APA-BCC微胶囊)植入癌痛患者脊髓蛛网膜下产生镇痛的同时对脑脊液中内源性阿片肽类物质含量的影响。方法:将APA-BCC微胶囊注射入晚期癌症并伴有中、重度疼痛患者的腰段脊髓蛛网膜下腔内;分别采取移植前、移植后6～8d的脑脊液,部分患者又采取了移植后13～17d的脑脊液;用放射免疫法检测脑脊液中亮氨酸脑啡肽(L-EK)、β-内啡肽(β-EP)、强啡肽(DynA)的含量。结果:与移植前比较,移植后患者脑脊液中L-EK的含量明显升高,其中移植剂量为1.0×107时,升高最为显著;而移植后脑脊液中β-EP和DynA的含量无明显改变。结论:APA-BCC微胶囊植入对癌痛患者的镇痛效应可能与脑脊液中L-EK的含量升高有关。
OBJECTIVE: To investigate the effect of sodium alginate-polylysine-alginate microencapsulated bovine adrenal chromaffin cells (APA-BCC microcapsules) on the analgesia induced by subarachnoid spinal cord in patients with cancer pain. Effects of opioid peptide content. Methods: APA-BCC microcapsules were injected into the subarachnoid space of the lumbar spinal cord of patients with advanced cancer accompanied by moderate and severe pain. Cerebrospinal fluid (CSF) was collected before transplantation and 6-8 days after transplantation, and some patients after transplantation The levels of L-EK, β-EP and DynA in cerebrospinal fluid were detected by radioimmunoassay. Results: Compared with that before transplantation, the content of L-EK in cerebrospinal fluid of patients after transplantation was significantly increased, and the most significant increase was at 1.0 × 107 transplanted dose. However, the content of β-EP and DynA in cerebrospinal fluid after transplantation did not change significantly . CONCLUSION: The analgesic effect of APA-BCC microcapsule implanted in patients with cancer pain may be related to the increase of L-EK in cerebrospinal fluid.