增强卡介苗与膀胱壁结合力的实验研究

目的为提高卡介苗的抗肿瘤作用提供实验依据.方法家兔30只,膀胱内分别行切割伤、电灼伤、冷冻伤后随机分成5组,每组6只.A组膀胱内单纯灌注磷酸盐缓冲液;B组膀胱内灌注磷酸盐缓冲液+同位素标记后的卡介苗(3H-卡介苗);C组灌注氨基已酸+3H-卡介苗;D组灌注氨甲苯酸+3H-卡介苗;E组灌注肝素+3H-卡介苗.随后切取各损伤处及未损伤处膀胱壁,消化后以液体闪烁计数器测定3H-卡介苗的结合量(单位次/min). 结果卡介苗在膀胱壁损伤处的结合量远高于未损伤处; C组、D组卡介苗的结合量(27809±6580、28772±6058)明显高于B组 (12462±2412); 与B组比较(χ2分别为5.12、5.09,均P＜0.01),差异均有非常显著意义.而E组卡介苗结合量则明显低于B组,也远低于C组与D组,统计学检验差异亦有非常显著意义.结论对家兔膀胱内灌注纤维蛋白溶解抑制剂可增强卡介苗与其膀胱壁的结合力,而纤溶促进剂肝素则作用相反,提示前者可提高卡介苗的抗肿瘤作用.

Enhancement of bacillus Calmette-Guerin attachment to the bladder wall: experimental study

Objective To provide experimentally a scientific basis for enhancement of bacillus Calmette-Guerin (BCG) antineoplstic effect. Methods Thirty rabbits were equally divided into five groups (groups A, B, C, D, and E) and the bladder mucosa of every rabbit was injured by electrocautery, cryocautery and incision on the left lateral wall, right lateral wall and posterior wall respectively. Then different drugs were instilled into bladders. Group A: pure phosphate-buffered sodium instillation (PBS); group B: PBS and radiolabeled BCG ( 3H-BCG) instillation; group C and group D: epsilon-aminocaproic acid or para-aminomethyl benzoic acid and 3H-BCG instillation; group E: heparin and 3H-BCG instillation. After instillation, every injured bladder wall and non-injured wall (anterior wall of bladder) were surgically removed and digested. The quantity of BCG adherence was determined by liquid scintillation counter. Results The quantity of BCG attached to injured bladder wall was significantly higher than that of non-injured wall (P<0.001). The mean level of group C or group D was significantly higher than that of group B (P<0.001) while the mean level of group E was significantly lower than that of group B (P<0.001). Conclusion For experimental rabbits, intravesical instillation of fibrin clot stabilizer EACA or PAMBA can enhance BCG attachment to the bladder wall while fibrin clot inhibitor heparin inhibits it.