钐153-乙二胺四甲撑膦和氯化锶对多发性骨转移瘤患者免疫状态的影响

为探讨钐１５３－乙二胺四甲撑膦酸（~（１５３）Ｓｍ－ＥＤＴＭＰ）和氯化锶（~（８９）ＳｒＣｌ_２）对多发性骨转移瘤 患者免疫状态的影响，用~（１５３）Ｓｍ－ＥＤＴＭＰ和~（８９）ＳｒＣｌ_２治疗多发性骨转移瘤病人８６例。分别测定患 者外周血红细胞、白细胞、Ｔ淋巴细胞亚群和血清中免疫球蛋白的含量及肿瘤坏死因子水平。 结果表明，单次~（１５３）Ｓｍ－ＥＤＴＭＰ和~（８９）ＳｒＣｌ_２治疗多发性骨转移瘤患者外周血红细胞、 Ｔ淋巴细胞 亚群和血清中免疫球蛋白的含量及肿瘤坏死因子水平治疗前后和两治疗组之间比较无显著差异 （Ｐ＜０．０５），白细胞虽有下降，但仍在正常范围内；随着药物放射剂量增加，病人骨髓毒性增 大，外周血红细胞、白细胞和血清中免疫球蛋白的含量降低，而Ｔ淋巴细胞亚群的分布未见变 化，说明常规用量的~（１５３）Ｓｍ－ＥＤＴＭＰ和~（８９）ＳｒＣｌ_２对患者的Ｔ淋巴细胞亚群、免疫球蛋白及肿瘤坏 死因子水平等无明显影响，但随着放射性剂量的增加，病人的免疫功能受到影响难以避免，并 可能以体液免疫首先受到抑制。

Induence of ~(153)Sm-EDTMP and ~(89)SrCl_2 on immune function in patients with multiple bone metastases

To investigate the influence of ~(153)Sm-EDTMP and ~(89)SrCl_2 on immune function in patients with multiple bone metastate. 86 cases of multiple bone metastases were treated with ~(153)Sm-EDTMP and ~(89)SrCl_2 during the period of 1995-1998. The patient's RBC, WBC, T lymphocyte subset, blood immunoglobulin and tumor necrosis factor(TNF) were also measured. Difference in the RBC, T lymphocyte subset, and immunoglobulin and TNF before and after therapy and also between ~(153)Sm-EDTMP and ~(89)SrCl_2 group both was not significant (P>0.05). Althrough the WBC have decreased, but still within normal range. As the dose of ~(153)Sm-EDTMP increased, the toxicity of bone narrow rose then the WBC and RBC of patient and blood IgG decreased, however, T lymphocyte subset has not changed. Common dosage of ~(153)sm-EDTMP and ~(89)SrCl_2 did not influence patient's immune function significantly. However with the increasing of therapeutic dose it's inevitable to influence their immune function and possible to effect the humonal function first.