以球囊携带液体188铼兔颈动脉腔内照射预防再狭窄的实验研究β-Irradiation with a liquid 188Re-filled balloon prevents neointimal proliferation in the carotid rabbit
朱建国,崔长琮,崔翰斌,马爱群,张斌,胡国英,王东琦
摘要(Abstract)：
目的 评价以球囊携带液体1 88铼 (1 88Re)兔颈动脉腔内照射预防再狭窄的可行性及作用。方法 12只兔颈动脉过大球囊损伤内膜后行1 88Re放射治疗 ,随机分为对照组 (n =6 )和照射组(n =6 ) ,管腔下 0 0 5mm处的吸收剂量为 15Gy。全部兔饲养 1周后活杀 ,取病理组织学标本进行分析。结果 照射组内膜面积明显小于对照组 [(0 0 4± 0 0 6 )mm2 vs (0 16± 0 0 4)mm2 ,P <0 0 5 ],管腔面积明显大于对照组 [(0 6 5± 0 0 5 )mm2 vs (0 35± 0 0 3)mm2 ,P <0 0 5 ],血管面积大于对照组[(1 0 4± 0 2 3)mm2 vs (0 81± 0 0 5 )mm2 ,P =0 0 4]。照射中央区管腔面积大于边缘区 [(0 6 5± 0 0 5 )mm2 vs(0 2 5± 0 0 6 )mm2 ,P <0 0 5 ],内膜面积小于边缘区 [(0 0 4± 0 0 6 )mm2 vs(0 12± 0 10 )mm2 ,P<0 0 5 ],内弹力板面积大于边缘区 [(0 70± 0 0 4)mm2 vs(0 37± 0 14)mm2 ,P =0 0 6 ],血管面积大于边缘区 [(1 0 4± 0 2 4)mm2 vs (0 6 3± 0 17)mm2 ,P <0 0 5 ]。结论 以球囊携带液体1 88Re血管腔内照射通过抑制内膜增生及血管重塑来减少再狭窄 ;边缘效应主要是由于血管的收缩性重塑引起的。
关键词(KeyWords)： 近距离放射治疗;再狭窄
基金项目(Foundation):
作者(Author): 朱建国,崔长琮,崔翰斌,马爱群,张斌,胡国英,王东琦
参考文献(References)：
- 1PopmaJJ,CaliffRM ,TopolEJ.Clinicaltrialsofrestenosisaftercoronaryangioplasty.Circulation,1991,84:14261436.
- 2RaiznerAE ,OesterleSN ,WaksmanR ,etal.Inhibitionofrestenosiswithbeta emittingradiotherapy:reportoftheproliferationreductionwithvascularenergytrial.Circulation,2000,102:951958.
- 3WangSJ,LinWY ,ChenMN ,etal.Biodistributionofrhenium188Lipiodolinfusedviathehepaticarteryofratswithhepatictumours.EurJNuclMed,1996,23:1317.
- 4WaksmanR .Localcatheter basedintracoronaryradiationtherapyforrestenosis.AmJCardiol,1996,78(3A):2328.
- 5ChougulePB .Vascularradiationtherapytoreducecoronaryarteryrestenosis.SurgOncolClinNAm,2000,9:577584.
- 6MintzGS ,PopmaJJ ,PichardAD ,etal.Arterialremodelingaftercoronaryangioplasty:aserialintravascularultrasoundstudy.Circulation,1996,94:3543.
- 7WexbergP ,KirisitsC ,GyongyosiM .Vascularmorphometricchangesafterradioactivestentimplantation:adose responseanalysis.JAmCollCardiol,2002,39:400407.
- 8KotzerkeJ,FenchelS ,GuhlmannA ,etal.Pharmacokineticsof99Tcm pertechnetateand188Re perrhenateafteroraladministrationofperchlorate:optionforsubsequentcareaftertheuseofliquid188Reinaballooncatheter.NuclMedCommun,1998,19:795801.
- 9HehrleinC ,StintzM ,KinscherfR ,etal.Pureβ particle emittingstentsinhibitneointimalformationinrabbits.Circulation,1996,93:641645.
- 10RaiznerAE ,OesterleSN ,WaksmanR ,etal.Inhibitionofrestenosiswithbeta emittingradiotherapy:ReportoftheProliferationReductionwithVascularEnergyTrial(PREVENT).Circulation,2000,102:951958.
- 11PalmerRM ,FerrigeAG ,MoncadaS .Nitricoxidereleaseaccountsforthebiologicalactivityofendothelium derivedrelaxingfactor.Nature,1987,327:524526.
- 12AlbieroR ,AdamianM ,KobayashiN ,etal.Short andintermediate termresultsof(32)Pradioactivebeta emittingstentimplantationinpatientswithcoronaryarterydisease:TheMilanDoseResponseStudy.Circulation,2000,101:1826.
- 13ZimarinoM ,WeissmanNJ ,WaksmanR ,etal.Analysisofstentedgerestenosiswithdifferentformsofbrachytherapy.AmJCardiol,2002,89:322325.
- 14KayIP ,WardehAJ,KozumaK ,etal.Thepatternofrestenosisandvascularremodellingaftercold endradioactivestentimplantation.EurHeartJ,2001,22:13111317.