Ozawa T, Kimura K, Koyanagi Y, Aoki T, Kusama M, Takagi S, Kakuta T, Yoshimatsu A, Ishikawa M, Yasuda D
Dept. of Surgery, Tokyo Medical College.
Gan To Kagaku Ryoho. 1988 Aug;15(8 Pt 2):2479-83.
The fundamental principles of intra-arterial infusion chemotherapy are thought to be increased local drug concentration and the "first-pass" effect. The concentration in the rest of the body can only be decreased if there is local elimination of the infused drug before reaching the systemic circulation. This is referred to as the "first-pass" effect. In the evaluation of "first-pass" effect, the uptake of liver after infusing 99mTc-human serum albumin (99mTc-HSA) in the hepatic artery by injecting the subcutaneously implanted silicon reservoir was compared with that obtained after intravenous administration of 99mTc-HSA. In order to remove the factor of portal infusion, each count of liver up take had been continued for only 24 seconds after starting the liver uptake. The results are as follows: for 24 cases excepting 6 cases with catheter obstruction, the mean i.a./i.v. ratio was 7.92 +/- 3.34 (range 3.25 to 17.25). Although the elimination rate of drugs in the liver varies with each drug, the infusion of intraarterial chemotherapy should be about 8 times more concentrative than intravenous administration on the "first-pass" effect.
动脉内灌注化疗的基本原理被认为是提高局部药物浓度和“首过”效应。只有在注入的药物在进入体循环之前被局部清除，身体其他部位的浓度才会降低。这被称为“首过”效应。在评估“首过”效应时，通过皮下植入的硅储器在肝动脉中注入99m锝-人血清白蛋白（99mTc-HSA）后肝脏的摄取情况与静脉注射99mTc-HSA后获得的情况进行了比较。为了消除门静脉灌注的因素，在开始肝脏摄取后，每次肝脏摄取计数仅持续24秒。结果如下：除6例导管阻塞病例外的24例患者，平均动脉内/静脉内比值为7.92±3.34（范围为3.25至17.25）。尽管肝脏中药物的清除率因药物而异，但在“首过”效应方面，动脉内化疗的输注浓度应比静脉给药高约8倍。
