99Tc-亚甲基二膦酸盐治疗多发性骨转移癌的临床观察

目的 观察99Tc-亚甲基二膦酸盐(云克,99Tc-MDP)对恶性肿瘤骨转移所至疼痛的治疗效果以及99Tc-MDP对人体Hb、WBC、血小板(PLT)、血清钙及PS评分的影响.方法 选择恶性肿瘤多发骨转移患者78例给予99Tc-MDP治疗.云克200 mg加入0.9%氯化钠注射液500 ml,缓慢静脉滴注2 h,每天1次,连续使用5 d.休息21～28 d,重复第2个周期.每例患者不少于3个周期.结果 99Tc-MDP对Hb、WBC、PLT治疗前后无影响,但对治疗前后的血清钙有明显的影响,可以显著降低高血钙(P＜0.01).对疼痛程度的缓解在治疗前后差异有统计学意义(P＜0.05).对人体力状况PS改善情况在治疗前后变化不明显,差异无统计学意义(P＞0.05).结论 99Tc-MDP治疗骨转移癌有一定的疗效,可以缓解骨转移癌引起的疼痛,对降低骨转移引起的高钙血症有一定作用.使用过程中未发生骨髓功能的抑制,无明显的消化道反应.

Clinical study of 99Tc-MDP in the treatment of multiple bone metastases cancer

Objective To observe the effect of 99Tc-MDP in the treatment of metastasis bone disease pain with malignancies,and the influence of 99Tc-MDP to human body's Hb,WBC,PLT,serum calcium,and PS grade.Methods 99Tc-MDP was used for the treatment of bone metastases in 78 cases with malignancies:established the intravenous access,mairdined with the 99Tc-MDP,200mg,the diluted physiological brine,and in tWO hours,once a day for five days.After the rest of twenty one to twenty-eight days,the second cycle Was repeated,and each patient at least three cycles.Results 99Tc-MDP had no influence to the Hb,WBC and PLT in pre-treatment and post-treatment,but had obvious effeet on the serum calcium,the hypocalcaemia reduced obviously(P＜0.01).There was significant difference in ameliorating ache during the periods of pretreatment and post-treatment(P＜0.05).However,there was no marked improvement in PS,and no statistic difference(P＞0.05).Conclusion 99Tc-MDP has deftnite curative effect in the treatment of metastasis bone cancer,can ameliorate the ache induced by it,and can reduce the hypoealcaemia.There is no marrow inhibition and enteron reaction in the application.