【摘要】 目的　研究1 88Re液体充盈球囊导管对兔血管再狭窄模型用不同剂量内照射后对增生内膜不同的剂量效应。方法　 16只新西兰白兔分成 2组 ,一侧下肢髂动脉行内膜剥脱术后 ,通过直径 2 5mm液体1 88Re充盈球囊导管分别给以 0、8和 15Gy剂量的血管内照射治疗。其中 8只兔的另一侧髂动脉仅行内膜剥脱术作为对照。 4周后处死动物 ,取出血管。组织经HE染色、VanGieson胶原染色、α 肌动蛋白免疫组化染色 ,通过图像分析系统分析 ,测定狭窄指数和增殖指数。结果　对照组、8和 15Gy组的狭窄指数分别为 0 49± 0 0 6、0 65± 0 0 5和 0 82± 0 0 5 ,增殖指数分别为 0 5 4±0 0 9、0 48± 0 0 6和 0 3 3± 0 0 4。 15Gy组增生的内膜明显下降 (P <0 0 5 ) ,而 8Gy组与对照组比较差异无显著性 (P >0 0 5 )。免疫组化显示增生的内膜主要是平滑肌细胞 (SMCs)。结论　在兔血管再狭窄模型中 ,用1 88Re液体充盈球囊导管内照射治疗 ,当接近血管内表面的吸收剂量达到 15Gy时能安全有效地抑制内膜平滑肌的增生更多还原

【Abstract】 Objective In an animal model of restenosis the effect of intravascular brachytherapy with a 188Re filled balloon catheter was investigated. Methods In 16 New Zealand white rabbits, after endothelial denudation of the two iliac arteries with 2.5 mm balloon catheter, endovascular irradiation was performed on either one of the two denuded iliac arteries with another 188Re filled 2.5 mm balloon catheter using different doses (0, 8,15 Gy at 0.05 mm from the surface of balloon) leaving the other one untreated as the control. Then 4 weeks after the intervention, the rabbits were sacrificed and the vessels were excised. For morphologic examinations the tissue sections were stained with HE and van Gieson staining. Smooth muscle cells (SMCs) were identified immunohistologically with an antibody against α-acting. The indexes of stenosis and proliferation were determined by image analysis system. Results The stenosis indexes of the control (0 Gy), 8 and 15 Gy groups were 0.49±0.06, 0 65±0.05, 0.82±0.05, respectively, and the proliferation indexes of the control, 8 and 15 Gy groups were 0.54±0.09, 0.48±0.06, 0.33±0.04, respectively. Neointimal hyperplasia was significantly lower at 15 Gy group (P<0.05) whereas at 8 Gy group the proliferation index did not differ significantly from the control group. Almost all neointimal consisted of SMCs as detected by α-acting staining. Conclusion At a radiation absorbed dose of 15 Gy at 0.05 mm from the surface of balloon, catheter transmitted endovascular irradiation with the liquid 188Re after endothelial denudation is feasible and effectively reduces neointimal hyperplasia in rabbit model.更多还原