留置不同类型镍钛记忆合金气管支架的动物实验研究  

Experimental study of different nickel-titanium memory tracheal stents in dogs

作　　者：郎旭[1] 贺能树[1] 范海伦[1] 

机构地区：[1]天津医科大学总医院放射科

出　　处：《国际医学放射学杂志》2009年第6期521-524,532,共5页International Journal of Medical Radiology

摘　　要：目的比较留置不同类型镍钛记忆合金气管支架后,实验犬的机体反应及气管增生情况,探讨不同气管支架植入的应用价值。方法健康成年杂种犬18只,随机平均分为3组,气管内留置不同类型支架。①组：留置全覆膜支架（全长6cm覆膜）;②组：留置中段覆膜支架（全长6cm,上下两端各1cm不覆膜,覆膜长度4cm）;③组：留置不覆膜支架（全长6cm）。术后观察进食、呼吸情况,饲养24周后分别处死。观察大体气管标本和镜下改变,并行增殖细胞核抗原染色,定量分析增生细胞的阳性表达。结果①各组实验犬均未发生支架留置后的急性呼吸困难,有轻至中度咳,均可正常饮水、进食,发声无异常。部分犬活动减少。②支架不覆膜处,气管内壁组织增生较明显,气管腔狭窄程度大于支架覆膜处。③苏木素-伊红（HE）染色镜下均表现为炎性反应,低柱状上皮细胞鳞状化生、肉芽增生和纤维增生性改变。④全覆膜组与不覆膜组,半覆膜组的覆膜处与不覆膜处的黏膜增殖细胞阳性表达的差异有统计学意义（P〈0.05）。不覆膜处的黏膜增殖细胞比率较高。结论①气管支架覆膜的有无在留置的短期内对于进食、呼吸状况无明显影响。②气管支架留置后,覆膜段气管内膜组织增生水平要低于不覆膜段。③气管支架留置后,覆膜段的黏膜增殖细胞阳性表达小于不覆膜段。覆膜支架的生物相容性好。Objective Since membrane-covered metal tracheal stent was applied successfully to treat the airway stenosis,it has been widely used and obtained satisfactory result during the past years. The purpose of our study was provide theoretical rational for treatment with membrane-covered tracheal stent by using animal experiment. Methods The nickel-titanium memory stents of 22 mm in diameter and 6 cm in length were deployed in 18 dogs. The dogs were grouped into full-length membrane-covered group （n=6）,partial-length membrane-covered group （membrane was covered for 4 cm in the medial part of the stent,n=6）,and naked stent group （n=6）. After the stent placement,dysphagia or dysphonia was monitored daily. Twenty-four weeks later,the dogs were executed. Speiments were taken from the cephalic,medial,and caudal trachea under the stent. HE stain and proliferating cell nuclear antigen（PCNA） were evaluated. Results After the stent placement,no dyspnea,dysphagia or dysphonia but cough was present in each dog. There was no significant difference in symptom between the three groups. Inflammation reaction,metaplasia from low columnar epithelium to spuamous epithelium,and mild granulation tissue hyperplasia in the underlying mucosa were present in each group. However,fibrosis and tracheal straitness were present only in the non-membrane-covered area,but not in the membrane-covered area. More PCNA expression was observed in the non-membrane-covered area than in the membrane-covered area. Conclusion Both membrane-covered and non-membrane-covered stents can cause similar symptoms. However,the membrane-covered tracheal stent has good biological compatibility and would not induce tracheal straitness. The non-membrane-covered tracheal stent could induce a severe pathologic reaction and tracheal straitness.

关 键 词：镍钛记忆合金气管支架 覆膜 动物实验 增殖细胞核抗原 

分 类 号：R730.55[医药卫生—肿瘤]