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目的 研究血管内放射源照射对损伤血管增生反应的影响。方法 30只常规喂养新西兰大白兔 ,用大于血管直径的球囊过度扩张兔双髂动脉 (球囊 /血管 =1 5 4∶1) ,造成血管壁损伤 ,同时在扩张的球囊中灌注放射性3 2 P进行一侧损伤血管内照射 ,一侧血管单纯扩张作自身对照。按不同照射剂量分成三组 :10Gy、2 0Gy和 40Gy ,每组 10只。在扩张前后进行血管造影 ,4周后再次血管造影同时处死动物取双髂动脉作平滑肌细胞、弹力纤维和胶原纤维染色 ,观察血管受损后放射对血管腔径及其管壁增生的影响。结果 4周后血管造影显示 ,三组兔髂动脉扩张损伤后均发生一定程度的狭窄反应 (P <0 0 0 1)。血管内照射一侧与对照侧比较 ,血管狭窄程度无明显差异 (P >0 0 5 )。病理组织分析 ,10Gy组照射一侧血管内膜增生与对照侧比较无差异 (P >0 0 5 ) ,而 2 0Gy和 40Gy二组照射一侧血管内膜增生较对照侧血管减少 (P <0 0 0 1,P <0 0 4) ,但二组间比较内膜增生减少无差异 (P >0 0 5 )。结论 过度扩张兔髂动脉可产生再狭窄样反应 ,血管内放射在 2 0Gy到 40Gy照射剂量时能减少血管损伤后内膜增生 ,但血管损伤后狭窄程度未受影响。
Objective To study the effect of intravascular radiation exposure on vascular injury. Methods Thirty New Zealand white rabbits were routinely fed New Zealand white rabbits. The double iliac artery (balloon / blood vessel = 15 4: 1) was over-dilated with a balloon larger than the diameter of the vessel, resulting in vascular wall injury and perfusion of the radioactive 3 2 P injury to one side of the vascular irradiation, blood vessels on the side of the simple expansion of their own control. Divided into three groups according to different irradiation doses: 10Gy, 20Gy and 40Gy, 10 in each group. Angiography was performed before and after dilatation. Simultaneous angiography was performed 4 weeks later. The animals were sacrificed and the iliac arteries were taken for smooth muscle cells, elastic fibers and collagen fibers to observe the effects of radiation on the luminal diameter and the proliferation of vascular wall. Results Angiography at 4 weeks showed that some degree of stenosis occurred in the iliac artery of all three groups after dilatation (P <0.01). There was no significant difference in the degree of vascular stenosis between the endovascular irradiation side and the control side (P> 0.05). The histopathological analysis showed that there was no difference between the 10Gy group and the control group (P> 0.05), but the intimal hyperplasia of the 20Gy group and the 40Gy group was lower than that of the control group (P <0. 05) 0 0 1, P 0 04), but there was no difference between the two groups in the reduction of intimal hyperplasia (P 0 05). Conclusions Over-dilatation of rabbit iliac arteries can produce restenosis-like response. Endovascular hyperplasia after vascular injury can be reduced by irradiation with 20Gy to 40Gy intravascular irradiation, but the degree of stenosis after vascular injury is not affected.