| 摘要: |
| 目的探讨盐酸氢吗啡酮对晚期乳腺癌患者的镇痛效果及血清疼痛相关激素水平的变化。方法将66例常规进行抗癌治疗的晚期乳腺癌癌痛患者按信封法随机分为研究组和对照组，各33例，研究组采用盐酸氢吗啡酮静脉镇痛泵治疗，对照组采用帕米磷酸二钠静脉镇痛泵治疗。分别于治疗前和治疗28d进行VAS评分和KPS评分，测定治疗前、治疗1、2、4个月的血清5-羟色胺（5-HT）、一氧化氮（NO）、前列腺素E2（PGE2）、皮质醇（Cor）、生长激素（GH）、泌乳素（PRL）等应激激素水平，并分析其血清疼痛介质及应激激素水平与其癌痛治疗效果以及KPS评分改善效果的关系。结果研究组VAS评分和KPS评分等级显著优于对照组，差异均有统计学意义（均P＜0.05）。与治疗前比较，两组治疗1、2、4个月的血清疼痛介质及应激激素水平均降低（均P＜0.05）。与对照组比较，研究组治疗1、2、4个月的激素水平均降低（均P＜0.05）。Spearman分析结果显示，晚期乳腺癌癌痛患者血清5-HT、NO、PGE2、Cor、GH、PRL水平与其癌痛治疗有效率和KPS评分均呈负相关（均P＜0.05）。结论盐酸氢吗啡酮静脉镇痛泵给药镇痛效果优于传统镇痛药物，其机制可能和盐酸氢吗啡酮对疼痛反应相关激素水平抑制作用更强有关。 |
| 关键词: 盐酸氢吗啡酮 疼痛相关激素 乳腺癌 |
| DOI：10.12056/j.issn.1006-2785.2018.40.8.2018-72 |
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| Analgesic effect of hydromorphone hydrochloride and stress-related hormone levels in breast cancer patients with chemotherapy |
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Zhoushan Hospital
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| Abstract: |
| Objective To investigate the analgesic effect of hytromorphone hydrochloride and serum levels of stress-related hormones in breast cancer patients with chemotherapy. Methods Sixty six advanced breast cancer patients with chemotherapy were randomly divided into 2 groups with 33 in each group: patients in study group received hydromorphone hydrochloride for analgesia and patients in control group received disodium pamidronate. The VAS, KPS score and serum 5-HT, NO, PGE2, Cor, GH and PRL levels were measured before and 1, 2, 4 months after treatment. Results The VAS and KPS scores of study group were significantly higher than those of control group(Z=6.79, P＜0.05; Z=7.10, P＜0.05). The serum levels of 5-HT, NO, PGE2, Cor, GH and PRL at 1, 2 and 4 months after treatment were significantly lower than those before treatment in both groups (P＜0.01 or P＜0.05); while the levels in study groups after treatment were lower than those in control group (P＜0.05). Spearman analysis revealed a negative correlation between VAS, KPS scores and stress-related hormone levels(VAS: r= -0.824,
-0.855, -0.738, -0.766, -0.825, -0.879; KPS: r =-0.788, -0.844, -0.865, -0.792, -0.815, -0.873, all P ＜0.05). Conclusion
Hydromorphone hydrochloride is more effective than disodium pamidronate in analgesia for advanced breast cancer patients with chemotherapy, which is associated with the inhibition of serum stress-related hormones levels. |
| Key words: Hydromorphone hydrochloride Stress-related hormone Breast cancer |
