温敏药物缓释栓塞剂行兔肝动脉栓塞的实验研究  

Hepatic artery embolization using thermosensitive and slow-release drug as embolic agents:an experimental study in rabbits

作　　者：万智勇[1] 张磊[1] 卢子瑄 张敏洁[1] 王彬[1] 段友容[2] 

机构地区：[1]上海市浦东新区浦南医院肿瘤介入科,200125 [2]上海市肿瘤研究所

出　　处：《介入放射学杂志》2011年第7期559-562,共4页Journal of Interventional Radiology

基　　金：上海市浦东新区科技发展基金创新资金PKJ2010-Y27

摘　　要：目的探讨温敏药物缓释栓塞剂行肝动脉栓塞治疗的可行性与疗效。方法选用新西兰大白兔15只,以自组包载＂碘海醇＂温敏缓释剂泊洛沙姆407（Pluronic~F-127）行肝动脉栓塞术,术后随访4周,定期复查肝功能、DSA、CT及动物处死后组织病理检查。结果术后丙氨酸转氨酶（ALT）和天冬氨酸转氨酶（AST）一过性增高,2周后恢复正常。术后即刻行肝动脉DSA造影,见栓塞区段以下分支完全性闭塞;4周复查造影显示栓塞小动脉未显示再通;术后1～2周CT复查可见栓塞区出现肝实质液化性梗死灶,4周仍见斑点状坏死灶。栓塞区高密度对比剂CT值随时间逐渐下降,持续时间达4周,并从中心区向边缘扩散。术后即刻行肝、肺病理检查见栓塞区肝动脉段一下分支被栓塞剂完全充填,肝窦内及门静脉肝静脉内未见栓塞剂,双肺动脉各级分支内未见栓塞剂;术后3 d,1、2、4周见窦前小动脉有条絮状栓塞剂和血栓混合物;肝小叶结构完全消失,周围见纤维结缔组织增生。结论温敏药物缓释栓塞剂在体温下快速形成固态,达到末梢动脉栓塞的效果,同时药物缓释持续时间达4周,是一种较为安全、理想的栓塞剂。Objective To explore the feasibility and effect of hepatic artery embolization by using thermosensitive and slow-release drug as embolic agents in experimental rabbits.Methods Hepatic artery embolization was carried out in fifteen New Zealand rabbits by using Lutrol F 127 as embolic material.The rabbits were followed up for 4 weeks.Examinations,including liver function,CT scanning and angiography were regularly conducted.Every three rabbits were sacrificed immediately after the procedure and each time at 3 days,1,2 and 4 weeks after the procedure.The specimens were collected and sent for histopathologic examination.Results After the operation,a transient elevation of ALT and AST level was observed in all rabbits,which reached its peak at the fifth day and turned to its initial level in two weeks.The complete occlusion of segmental artery branches and distal branches was achieved immediately after the embolization and no recanalization was detected on DSA performed 4 weeks after the operation.The liquefaction necrosis of liver parenchyma was demonstrated on CT scanning performed 1 to 2 weeks after the treatment,and punctate necrosis foci were still seen in 4 weeks.The CT value of the high-density lesions located within the embolized region gradually decreased with the time.This changing process of CT value spread from lesion＇s center to lesion＇s margin and lasted for 4 weeks.Pathological examination conducted immediately after the embolization showed that the tiny hepatic arteries were completely filled with Lutrol~ F 127,and no embolic material could be found in hepatic sinusoids,portal veins or pulmonary arteries.At the 3th day and 1st,2nd,4th week,Lutrol~ F 127 together with thrombosis was found in pre-sinusoidal arterioles and meanwhile complete disappearance of hepatic lobules with hyperplasia of interlobular connective tissue could also be seen.Conclusion In the environment of body temperature,the thermosensitive and slow-release drug used as an embolic agent will quickly transform into solid st

关 键 词：栓塞剂 药物缓释 温度敏感 栓塞治疗 实验性 

分 类 号：R735.7[医药卫生—肿瘤]