兔髂动脉腔内照射预防血管成形术后再狭窄实验研究初报.docVIP

???? 兔髂动脉腔内照射预防血管成形术后?再狭窄实验研究初报 ???? ????摘要】目的　评价兔髂动脉内近距离治疗预防经皮经腔血管成形术(PTA)后再狭窄的可行性及作用。方法　 29只兔髂动脉进行PTA后制成动脉狭窄模型，4周后将狭窄病灶分为3个组：(1)8只作为对照组，仅作PTA；(2)9只PTA后192Ir腔内照射10 Gy；(3)12只PTA后192Ir腔内照射18 Gy。全部兔饲养4周后活杀，取病理组织学标本进行分析。结果　新内膜面积1～3组分别为(13.85±6.92) μm2，(14.79±3.34) μm2，(5.10±2.12) μm2(P0.05)；管腔面积1～3组分别为(4.24±1.49) μm2，(3.58±3.37) μm2，和(12.31±5.57) μm2(P0.05)；狭窄面积1～3组分别为(0.63±0.40) μm2，(0.78±0.15) μm2，(0.54±0.14) μm2(P0.05)；管腔壁最大厚度1～3组分别为(799.50±184.57) μm，(891.60±137.00) μm，(312.33±56.80) μm(P0.05)。对各组内膜、中膜的平滑肌细胞中的肌动蛋白(Actin)含量积分吸光度和单位平均吸光度的测定，18 Gy组数值明显低于对照组及10 Gy组(P0.05)；各组增殖细胞核抗原(PCNA)染色阳性率，18 Gy组明显低于10 Gy组及对照组(P0.05)。结论　血管腔内192Ir-γ线照射在技术上可行，可在介入治疗室中安全进行。18 Gy能有效的抑制新内膜的增生。　　【关键词】经皮经腔血管成形术　近距离治疗　放射治疗　预防再狭窄 Intra-arterial brachytherapy prevents restenosis in a rabbit iliac artery following percutaneous transluminal angioplastySHEN Wenjiang,WANG Junjie,YU Shiping,et al.Department of Radiation Oncology,First Hospital,Beijing Medical University, Beijing 100034 　　【Abstract】Objective　To evaluate the role of intra-arterial brachytherapy to prevent the iliac artery restenosis in the rabbit following percutaneous transluminal angioplasty (PTA). 　Methods　Twenty-nine iliac arteries in the rabbit underwent artery angiography. One segment of the iliac artery was chosen as the target for balloon injury and was built into an artery stenosis model. Four weeks later, the stenotic lesions were divided into three groups. In eight and twelve rabbits, a ribbon of 192　Ir was positioned at the target segment and 10 Gy,18 Gy was delivered at the vessel wall separately.Before that,overdilation balloon angioplasty had been performed at the irradiated segment.All animals survived and were sacrificed on D 28. Histopathologic analysis was performed. 　Results　In the control group, the neointimal area (mean ±SD) was (13.85±6.92) μm2 as compared with (14.79±3.34) μm2 of the 10 Gy irradiated group and (5.10±2.12) μm2in the 18 Gy group (P0.05).In the control group, the lumen area (mean ±SD) was