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目的:观察经犬肾动脉灌注平阳霉素(PYM)和平阳霉素碘油乳剂(PLE)产生的肾血管损伤,以验证PLE对血管的栓塞作用。方法:29只雄性家犬分3组:假手术组、PYM组和PLE组。PYM组在药物灌注后1、7和14天取材,PLE组在1、3、7、14、28和56天取材,观察各组肾血管的病理改变。结果:PYM组药物灌注后1天表现为局灶性血管内膜轻度肿胀,以肾小球毛细血管袢为主;7天内膜肿胀减轻;14天内膜形态基本恢复正常。PLE组早期(1～7天),肾脏毛细血管袢和动脉中膜(以小叶间动脉和入球小动脉为主)纤维素样坏死,伴血栓形成和血管周围炎细胞浸润;后期(14～56天)以血管壁平滑肌增生和纤维化,管腔狭窄和闭塞为主;两组均对静脉损伤轻微。结论:PLE较单纯PYM对肾血管的损伤作用早且持久,可能作为一种新的末梢栓塞剂用于临床血管栓塞术。
OBJECTIVE: To observe the renal vascular injury induced by perfusion of PYM and PYL in canine renal artery to verify the embolization effect of PLE on blood vessels. Methods: 29 male dogs were divided into 3 groups: sham operation group, PYM group and PLE group. The PYM group was drawn on the 1st, 7th and 14th day after the drug was infused. The PLE group was taken on the 1st, 3rd, 7th, 14th, 28th and 56th day to observe the pathological changes of the renal vessels in each group. Results: In the PYM group, the focal swelling of the intima appeared mainly on 1 day after perfusion. The glomerular capillaries were mainly located in the PYM group. The swelling of the membrane was relieved within 7 days. The morphology of the membrane returned to normal within 14 days. In the PLE group, fibrosis of the capillaries of the kidneys and the middle arteries (mainly interlobular and arteriolar arterioles) with thrombosis and perivascular inflammatory cells were observed in the early stage (P < 56 days) with vascular smooth muscle hyperplasia and fibrosis, stenosis and occlusion of the main; both groups of slight vein damage. Conclusion: PLE is more effective than PYM on renal vascular injury and may be used as a new peripheral embolization agent for clinical vascular embolization.