CAJ | 학술논문

目的观察癌痛患者接受阿片类药物镇痛治疗前后体内β-内啡肽(BE)的血浆浓度变化,探讨镇痛治疗疗效与血浆BE浓度的关系.方法选取应用阿片类缓释制剂治疗的癌痛患者42例,在治疗前接受数字分级疼痛评分(NRS),并利用放免法检测治疗前BE血浆浓度.1周后疼痛控制后复查NRS和BE血浆浓度.结果患者治疗前后BE血浆浓度有统计学差异[(17.92±3.43)pg/ml vs(27.73±5.10)pg/ml,P<0.05],治疗前后NRS评分也有统计学差异[(6.93±1.73)分vs(2.24±0.88)分,P<0.05].相关性分析提示治疗前后患者的NRS评分和BE浓度均呈负相关(均P<0.05).结论癌痛患者使用阿片类药物镇痛的疗效和体内BE浓度有关,定期监测患者血浆BE浓度有助于评估镇痛治疗疗效.
목적관찰암통환자접수아편류약물진통치료전후체내β-내배태(BE)적혈장농도변화,탐토진통치료료효여혈장BE농도적관계.방법선취응용아편류완석제제치료적암통환자42례,재치료전접수수자분급동통평분(NRS),병이용방면법검측치료전BE혈장농도.1주후동통공제후복사NRS화BE혈장농도.결과환자치료전후BE혈장농도유통계학차이[(17.92±3.43)pg/ml vs(27.73±5.10)pg/ml,P<0.05],치료전후NRS평분야유통계학차이[(6.93±1.73)분vs(2.24±0.88)분,P<0.05].상관성분석제시치료전후환자적NRS평분화BE농도균정부상관(균P<0.05).결론암통환자사용아편류약물진통적료효화체내BE농도유관,정기감측환자혈장BE농도유조우평고진통치료료효.
@@@@Objective To investigate the association of plasmaβ-endorphin(BE)levels with cancer pain relief in patients receiving different opioid analgesic modalities. Methods The prospective interventional study was conducted in 42 opi-oid-naieve patients with cancer pain due to lung, liver and gastric malignancies. After initiate opioid titration, pain relief was pro-vided with the fol owing modalities:oral continuous release morphine, oxycodon or transdermal fentanyl. Blood samples were tak-en before treatment and one week later with stable pain relief obtained by various treatment modalities. Plasma BE levels were measured by competitive radioimmunoassay using 125I β-endorphin. Pain levels were determined using a Numerical Rating Scale. Results Average pain scores decreased from 6.93±1.73 (SD) before treatment to 2.24±0.88 (SD) after treatment (P<0.0001). Satisfactory pain relief was obtained with each of the three treatment modalities and was associated with a significant in-crease in plasma BE levels. The mean plasma BE level for al groups was 17.92±3.43 pg/ml before treatment, and that was in-creased to 27.73±5.10 pg/ml after pain relief by three analgesic modalities (P<0.05). Conclusion Plasma BE levels increased with improved pain control in patients with malignancies, which suggests that plasma BE levels may serve as an objective mea-sure of cancer pain severity.