目的探讨氨磷汀对早期中耳放射损伤的防护作用。方法将38只豚鼠分为A、B、C、D、E5组,其中E组为空白对照,A、C组为单纯照射,B、D组为照射加用氨磷汀。照射豚鼠以60钴γ射线照射右耳,3.0Gy/次,总剂量45Gy,每周5次。加用氨磷汀的豚鼠每次照射前30min腹腔内注射氨磷汀100mg/kg。分别于照射45Gy后第2天和第30天处死豚鼠,行光镜及扫描电镜检查,观察各组豚鼠照射侧中耳黏膜病理和超微结构改变。结果经45Gy射线照射后第2天,豚鼠中耳黏膜上皮增厚,炎性细胞浸润,纤毛倒伏、融合,渗出增多;照射后第30天中耳黏膜上皮纤毛脱落、减少,损伤加重;照射前应用氨磷汀的豚鼠中耳黏膜均未见明显损伤;未用药组较用药组中耳黏膜厚度及白细胞浸润数增高(均P<0.01)。结论射线可致中耳黏膜黏液纤毛输送系统功能受损,并随时间推移而加重;氨磷汀可以减轻中耳的早期放射损伤,可望用于临床。 Objective To investigate the protective effect of amifostine on early middle ear radiation injury. Methods Thirty-eight guinea pigs were divided into groups A, B, C, D and E5. E group was blank control, A and C groups were irradiation alone, B and D groups were irradiated plus amifostine. Guinea pigs were irradiated with 60Co γ-rays to the right ear at 3.0 Gy per dose for a total dose of 45 Gy 5 times per week. Amifostine-added guinea pigs were injected intraperitoneally with amifostine 100 mg / kg 30 min before each irradiation. Guinea pigs were sacrificed on the 2nd day and the 30th day after exposure to 45Gy respectively. The pathological and ultrastructural changes of the middle ear mucosa were observed under light and scanning electron microscopy. Results On the second day after irradiation with 45Gy ray, the middle ear mucosa epithelial thickening, infiltration of inflammatory cells, ciliary lodging, fusion and exudation were increased in guinea pigs. On the 30th day after irradiation, the epithelial mucocutaneous epithelial cilia shed, reduced and the damage increased. No significant damage was observed in the middle ear mucosa of amniotic fluid before administration of amifostine. The thickness of the middle ear mucosa and the leukocyte infiltration in the untreated group were higher than those in the untreated group (all P <0.01). Conclusions Radiation can impair the mucociliary delivery system of the middle ear mucosa and worsen with the passage of time. Amifostine can reduce early radiation injury of the middle ear and is expected to be used clinically.