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目的 通过研究膀胱内灌注纤维蛋白溶解抑制剂对卡介苗 (BCG)与膀胱壁结合力的影响 ,探讨提高BCG抗肿瘤疗效的新方法。方法 将30只家兔在膀胱内分别行切割伤、电灼伤、冷冻伤后随机分成5组。A组膀胱内单纯灌注PBS液 ,B组灌注PBS液 +同位素标记后的BCG(3H -BCG) ,C组灌注氨基已酸 (EACA) +3H -BCG ,D组灌注氨甲苯酸 (PAMBA) +3H -BCG ,E组灌注肝素 +3H -BCG。随后切取各损伤处及未损伤处膀胱壁 ,测定其 3H -BCG的结合量。 结果 BCG在膀胱壁3种损伤处的结合量均远高于未损伤处 (均P<0.01) ;C、D组BCG的结合量均明显高于B组 (均P<0.01) ;而E组BCG结合量则明显低于B组 (P<0.01)。 结论 膀胱内灌注纤维蛋白溶解抑制剂可增强BCG与膀胱壁的结合力 ,而纤溶促进剂肝素则作用相反 ,提示前者可提高BCG的抗肿瘤疗效。
Objective To investigate the effect of intravesical fibrinolysis inhibitor (BCG) on the binding capacity of BCG to the bladder wall and to explore a new method to improve the antitumor efficacy of BCG. Methods Thirty rabbits were randomly divided into 5 groups randomly. Group B received perfusion of PBS solution + isotope labeled BCG (3H-BCG), Group C received infusion of aminocaproic acid (EACA) + 3H-BCG, Group D received infusion of PAMBA + 3H-BCG, E group perfusion of heparin + 3H -BCG. Subsequently, the injured and uninjured bladder walls were cut and the bound amount of 3H-BCG was measured. Results The amount of BCG binding in the bladder wall was significantly higher than that in the non-injured area (all P <0.01). The binding capacity of BCG in group C and D were significantly higher than that in group B (all P <0.01) The amount of BCG binding was significantly lower than that of group B (P <0.01). Conclusion Intravesical instillation of fibrinolytic inhibitors can enhance the binding capacity of BCG to the bladder wall, while fibrinolytic enhancer heparin has the opposite effect, suggesting that the former can enhance the antitumor efficacy of BCG.