5-氟尿嘧啶局部治疗兔瘢痕性喉气管狭窄的实验研究  

Experimental study of 5-fluorouracil in the topical treatment of laryngotracheal stenosis in rabbit models

作　　者：杨希之[1] 毛小慧[1] 敖华飞[1] 顾健[1] 孔德秋[1] 

机构地区：[1]上海交通大学医学院附属第三人民医院耳鼻咽喉头颈外科,上海201900

出　　处：《中国耳鼻咽喉颅底外科杂志》2011年第3期175-180,共6页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：上海市卫生局青年基金项目资助(2010Y141)

摘　　要：目的评价5-氟尿嘧啶(5-Fu)对兔瘢痕性喉气管狭窄的疗效。方法新西兰兔2 0只,利用尼龙刷刮擦法,刮除气管黏膜约0.5 cm宽度,诱导气管内瘢痕形成,将诱导瘢痕性喉气管狭窄成功的模型动物随机分为两组,每组10只,用5-Fu(A组)和生理盐水(B组)均于刮擦后7 d经气管穿刺瘢痕内注射给药,用药后4、8、12、16、20、24 d纤维喉镜下观察气管狭窄情况,并以用药日记作0天计算生存时间,利用Kaplan-Meier法计算生存率和绘制生存曲线,并做log-rank检验。结果 5-Fu组生存时间明显长于生理盐水组(P=0.0128);组织学观察,A组成纤维细胞和胶原纤维稀疏分散分布,主要位于组织深部,黏膜组织呈不均匀分布于刮擦区表面;B组管腔内刮擦区域充满了由增生的纤维细胞以及胶原纤维组成的瘢痕组织。结论 5-Fu对兔瘢痕型喉气管狭窄的治疗有一定的效果,可以作为喉气管狭窄的治疗方法进行进一步研究。Objective To evaluate the efficacy of 5-fluorouracil（5-Fu） in treatment of laryngotracheal stenosis in rabbit models.Methods Tracheal menbrane of 20 New Zealand rabbits was scraped about 0.5cm with a nylon brush to induce scar formation,and then randomly divided into 2 groups： 5-Fu group and saline group.Intralesional 5-Fu injection by tracheal puncture was given for seven days after surgery.The stenosis degree was observed under laryngofiberoscope at days 4,8,12,16,20,24 after administration.The day of administration as day 0,survival of animals was monitored.A survival curve was obtained by the Kaplan-Meier method and analyzed by the log-rank test.Results Survival time in the 5-Fu group was significantly prolonged compared to that in the control group（P=0.0128）.Histologic photomicrographs of 5-Fu group showed that granulation tissue formation was rarely seen in the scraped lesion.The remain granulation tissue was patchy in distribution over the lesion.Most of the patchy granulations were located in deep layer of the tracheal rather than in superficial layer.Howener,in the control group dense granulation tissue composed of proliferating fibroblasts and thickened collagen fibers was seen in the scraped lesions.Conclusion 5-Fu can prevent airway stenosis in rabbit models.

关 键 词：5-氟尿嘧啶 喉气管狭窄 瘢痕性 狭窄度 局部治疗 

分 类 号：R766.7[医药卫生—耳鼻咽喉科]