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目的 通过监测阿霉素 (ADM)的血药浓度 ,比较支气管动脉灌注与静脉全身化疗在药代动力学方面的差异。方法 (1)动物实验组 :家兔 2 4只 ,观察ADM单独用药或与DDP、MMC不同方式配伍时药代动力学参数的变化。 (2 )临床研究组 :原发性中心型肺癌 17例 ,采取联合用药 (ADM +DDP +MMC)支气管动脉灌注化疗。分别取动、静脉血 ,以荧光分光光度法测定血浆中阿霉素浓度。结果 线性范围在 10 1～ 10 6ng/ml内 ,r=0 .9983。日内标准误差 (s) <2 % ,日间s <3%。动物实验组单用ADM者血药浓度 时间方程为Cμg/ml=12 9.44e-13 .3 6t+0 .2 5e-0 .0 72t;三药配伍者为Cμg/ml=370 .93e-2 3 .4 3t+0 .0 4e-0 .0 9t。临床研究组动脉血样为Cμg/ml=44 8.6 1e-66.62t+16 .35e-8.13t;静脉血样为Cμg/ml=15 6 9e-2 1.66t+0 0 7e-0 .0 3 8t。结论 从药代动力学的角度衡量 ,ADM联合用药灌注化疗治疗支气管肺癌 ,是一种药效高、毒副作用低的治疗方法。
Objective To compare the pharmacokinetics of bronchial artery perfusion with intravenous systemic chemotherapy by monitoring the plasma concentration of adriamycin (ADM). Methods (1) Animal experimental group: Twenty-four rabbits were used to observe the changes of pharmacokinetic parameters of ADM alone or in combination with DDP and MMC. (2) Clinical study group: 17 patients with primary central lung cancer were treated with ADM + DDP + MMC bronchial arterial infusion chemotherapy. The blood and venous blood were taken respectively, and the concentration of doxorubicin in plasma was measured by fluorescence spectrophotometry. Results The linear range was from 10 1 to 10 6 ng/ml, r=0.9983. Intraday standard error (s) < 2%, daytime s <3%. The time equation of blood concentration of ADM in animal experimental group was Cμg/ml=12 9.44e-13.3 6t+0.25e-0. 0 72t. The compatibility of three drugs was Cμg/ml=370.93e-2. 3 .4 3t+0 .0 4e-0 .0 9t. The clinical study group had arterial blood samples of Cμg/ml=448.6 1e-66.62t+16.35e-8.13t; venous blood samples had Cμg/ml=15 6 9e-2 1.66t+0 0 7e-0. 0 3 8t. Conclusion From the perspective of pharmacokinetics, ADM combined with drug infusion chemotherapy for bronchial lung cancer is a treatment with high efficacy and low toxic and side effects.