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[阿糖胞苷鞘内灌注对犬的神经毒性及鞘内药代动力学]

[Intrathecal perfusion of ACNU neurotoxicity and intrathecal pharmacokinetics in dogs].

作者信息

Kochi M, Kuratsu J, Mihara Y, Inoue N, Takaki S, Sueyoshi N, Soyama N, Uemura S, Ushio Y

机构信息

Department of Neurosurgery, Kumamoto University Medical School, Japan.

出版信息

No Shinkei Geka. 1989 Aug;17(8):741-6.

PMID:2586715
Abstract

We studied the feasibility of intrathecal ACNU perfusion therapy against subarachnoid dissemination of malignant glioma. Intrathecal perfusion was performed in adult dogs by constant drip administration of 1 to 2 mg ACNU dissolved in 10 to 20 ml of lactate Ringer solution into the lateral ventricle and cerebrospinal fluid drainage through the lumbar puncture. The perfusion time was changed from 15 to 71 min. A bolus injection of 2 mg ACNU was also tested in one dog. No neurological symptom was noted during and after perfusion, and histological examination reveal only a minimum denudation of ependyma in a small area. Concentration of ACNU in CSF and serum were measured by HPLC (high-performance liquid chromatography). ACNU was detected in lumbar CSF only by perfusion, not by bolus injection, and the maximum concentrations were 6.26 to 25.76 micrograms/ml. The elimination phase of ACNU in lumbar CSF followed linear kinetics and the half-time was 18 min on average. AUCs (area under the drug concentration-time curve) were 346 to 896 micrograms.min/ml and they were the equivalent of in vitro cell kills in excess of 3 logs for rat 9L gliosarcoma and human glioma 126 cells. Serum concentration was 0.10 micrograms/ml in maximum. These findings suggest the feasibility of intrathecal ACNU perfusion therapy against subarachnoid dissemination of malignant glioma and warrant further studies.

摘要

我们研究了鞘内注射阿糖胞苷(ACNU)灌注疗法治疗恶性胶质瘤蛛网膜下腔播散的可行性。通过将1至2毫克ACNU溶解于10至20毫升乳酸林格液中,经侧脑室持续滴注并通过腰椎穿刺进行脑脊液引流,对成年犬进行鞘内灌注。灌注时间从15分钟至71分钟不等。还对一只犬进行了2毫克ACNU的静脉推注试验。灌注期间及之后均未观察到神经症状,组织学检查仅发现小面积室管膜有轻微剥脱。通过高效液相色谱法(HPLC)测定脑脊液(CSF)和血清中ACNU的浓度。仅通过灌注在腰段脑脊液中检测到ACNU,静脉推注未检测到,最大浓度为6.26至25.​​76微克/毫升。腰段脑脊液中ACNU的消除期呈线性动力学,平均半衰期为18分钟。药物浓度-时间曲线下面积(AUCs)为346至896微克·分钟/毫升,相当于对大鼠9L胶质肉瘤和人胶质瘤126细胞的体外细胞杀伤超过3个对数。血清最大浓度为0.10微克/毫升。这些结果表明鞘内注射ACNU灌注疗法治疗恶性胶质瘤蛛网膜下腔播散具有可行性,值得进一步研究。

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