家兔PICC静脉化疗动物模型血管病理变化研究  

Study on Vascular Pathological Changes in PICC Intravenous Chemotherapy Animal Model in Rabbits

作　　者：黄利全[1] 陈桂园[1] 胡庆华 胡波 方露燕[1] HUANG Liquan;CHEN Guiyuan;HU Qinghua;HU Bo;FANG Luyan(Jinhua Polytechnic,Jinhua 321017,China;Jinhua Hospital of Traditional Chinese Medicine,Jinhua 321017,China;Jinhua People's Hospital,Jinhua 321000,China)

机构地区：[1]金华职业技术学院,金华321017 [2]金华市中医院,金华321017 [3]金华市人民医院,金华321000

出　　处：《实验动物科学》2022年第1期49-54,共6页Laboratory Animal Science

基　　金：浙江省科技厅实验动物项目(2018C37095)。

摘　　要：目的探讨经外周置入中心静脉导管(PICC)化疗药物对置管静脉的损伤及病理变化,为化疗性静脉损伤发病机制研究和有效的防护方案提供可靠的实验依据。方法将48只实验兔按随机数字表法分为第1天组(对照),实验组分为:第2、3、7、14、21、23天和24天,成功建立PICC实验兔模型;于置管后第2天和第23天各注射1次酒石酸长春瑞滨注射液(以下简称长春瑞滨),剂量为25 mg/m^(2);分别在上述8个时间点取实验兔血液标本,检测凝血指标与免疫指标;同时提取PICC管两段,每段长约5 cm;截取实验兔耳缘静脉与前腔静脉两段血管,每段长约3 cm。光镜下观察并比较上述8组实验兔不同部位的静脉损伤情况以及血液C反应蛋白(CRP)、E-选择素(E-Selectin)、P-选择素(P-Selectin)、白介素-2(IL-2)、白介素-6(IL-6)、血小板计数(PLT)、凝血酶原时间(PT)、D-二聚体(D-dimer)等指标的动态变化。结果随置管与化疗药物的使用,耳缘静脉,呈现出第1天(对照)形成瘢痕、第2天(首次给药)少量血栓、第3天无血栓、第7天形成瘢痕、第14天少量血栓、第21天无瘢痕无血栓、第23天(再次给药)形成瘢痕以及第24天无瘢痕无血栓的动态变化;前腔静脉持续伴有不同程度的炎症细胞浸润。免疫指标与凝血指标中:CRP、E-Selectin、P-Selectin和IL-6升高、IL-2和PLT下降、PT缩短及D-dimer时间延长。随化疗间歇期的延长,静脉血栓与炎症改善明显;对照组与实验组比较,差异极显著(P<0.01)。结论PICC置管24 h出现静脉炎,注射长春瑞滨后,血管损伤加重,并形成静脉血栓,经化疗的间隙期,损伤血管明显好转。Objective To explore the damage and pathological changes of peripherally inserted central catheter(PICC)chemotherapeutic drugs to catheterized vein,and to provide reliable experimental basis for the study of the pathogenesis of chemotherapeutic vein injury and the effective prevention plan.Method Forty-eight laboratory rabbits were divided into 8 groups according to the random number table method:day 1(the control group),day 2,day 3,day 7,day 14,day 21,day 23 and day 24.Successfully established in the PICC laboratory rabbit model,vinorelbine injection(dose 25 mg/m^(2))was injected once on the day 2 and day 23 after the catheterization,and blood samples were taken at the above 8 time points to test the coagulation indexes and immune indexes.To observe and compare the venous injury in different parts of the 8 groups of laboratory rabbits under light microscope,as well as the dynamic changes of CRP,E-Selectin,P-Selectin,IL-2,IL-6,PLT,PT,D-dimer and other indicators.Result The auricular vein catheterization and the use of chemotherapy drugs showed scar formation on day 1(the control group),a small amount of thrombosis on day 2(first injection of vinorelbine),no thrombosis on day 3,scar formation on day 7 and there was a small amount of thrombosis on day 14,no scar and no thrombosis on day 21,scar formation on day 23(reinjection of vinorelbine),and no scar and no thrombosis on day 24.The anterior vena cava was continuously infiltrated with inflammatory cells of varying degrees.CRP,E-selectin,P-selectin,IL-6 values increased,IL-2 decreased,PLT decreased,PT shortened and D-dimer prolonged.With the extension of chemotherapy interval,venous thrombosis and phlebitis improved significantly.There was significant difference between the control group and the other seven groups(P<0.01).Conclusion Phlebitis occurred within 24 hours of PICC catheterization.Vascular injury and venous thrombosis were aggravated after the injection of vinorelbine injection.However,the damaged blood vessels were obviously improved after the intermitt

关 键 词：PICC 静脉化疗 动物模型 病理 

分 类 号：Q95-3[生物学—动物学]