^(32)P球囊内放射治疗预防动脉损伤后新生内膜过度增生  

Radiation therapy for neointimal proliferation using ^(32)P radioactive balloon in rabbit carotid injury models

作　　者：章希炜[1] 杨宏宇[1] 陈国玉[1] 卢辉俊[1] 高志伟[1] 

机构地区：[1]南京医科大学第一附属医院血管外科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2005年第12期894-897,F0002,共5页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的:选用家兔颈动脉球囊损伤模型观察放射性32P液体球囊血管内放射治疗对损伤后新生内膜过度增生的抑制作用。方法:健康家兔40只制作颈动脉球囊损伤模型,随机分成4组:10、20和40GY放射剂量治疗组和对照组。分别于术后3、7、14、28和56天处死动物,取颈动脉标本HE染色、原位标记凋亡细胞(TUNEL)和增殖细胞核抗原(PCNA)免疫组化染色,应用光学显微镜和计算机图像分析系统对切片进行图像分析,计算动脉中膜血管平滑肌细胞凋亡率、PCNA阳性率、内膜和中膜厚度及面积、残余管腔面积。结果:球囊损伤后动脉中膜平滑肌细胞开始增殖,并向内膜下迁移,其凋亡率和PCNA细胞阳性率均在伤后7天达到高峰。各治疗组各时间段血管平滑肌细胞凋亡率高于对照组(P<0.01),PCNA细胞阳性率低于对照组(P<0.01),20GY和40GY组相似,但都优于10GY组(P<0.01);伤后28天始血管内膜和中膜增厚,面积增加,残余管腔面积缩小,各治疗组伤后28天始血管内膜、中膜增厚面积增加和残余管腔面积缩小明显改善(P<0.01),20GY和40GY组相似,但都优于10GY组(P<0.01)。结论:放射性32P液体球囊血管内放射治疗可以明显抑制球囊损伤后动脉血管壁平滑肌细胞的增殖和迁移,减少新生内膜过度增生,预防管腔狭窄。Objective ：To investigate the effects of intravascular radiation with ^32p radioactive balloon on neointimal hyperplasia in rabbit carotid balloon-injuried models.Methods： Forty rabbit models of carotid balloon injury were randomly devided into one vehicle treatment （control） group and three intravascular radiation treatment groups （n = 10）.Radiation treatment groups received a radiation dose of 10GY,20GY,40GY （^32P）respectively while control group received treatment with normal saline balloon.Two rabbits of each groups were killed with over anaesthesia and the common carotid of both sides were harvested for pathomorphological examination 3,7,14,28,56 days after injury.The vessels were processed to examine VSMCs proliferation by hematoxylin-eosin staining,proliferation cell nuclear antigen （PCNA）immunohistochemistry staining and apoptotic body staining by terminal deocynucleotidyl transferase mediated dUPT nlck-end labeling （TUNEL）.Results：VSMCs apoptosis rate increased in control group and got to its peak at 7 days after injury.Compared with control group,VSMCs apoptosis rates in radiation groups were significantly higher （P 〈 0.01）.The expression rates of PCNA increased in control group and got to the peak at 7 days after injury, But which were significantly lower in radiation groups （P 〈 0.01 ）.Neointimal and media thickness of carotid were increased gradually in all groups. Intravascular radiation inhibited intimal and media thickness significantly （P 〈 0.01 ）.Compared with 10GY dose group,The effects in 20GY and 40GY group were more significant （P 〈 0.01 ）;There was no significant difference between 20GY and 40GY groups. Conclusion：Intravascular radiation with ^32p balloon inhibits neointimal hyperplasia after carotid injury through modulating proliferation and apoptosis of VSMCs.

关 键 词：^32P液体球囊 血管内放射 兔颈动脉球囊损伤模型 血管壁平滑肌细胞 

分 类 号：R654.3[医药卫生—外科学]