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目的探索高强度聚焦超声波(high intensity focused ultrasound,HIFU)杀伤棘球蚴(Echinococcus cysts)的效果。方法采集感染棘球蚴的新鲜羊肝,选取囊壁较薄、触摸弹性较好、直径<50 mm的棘球蚴囊25个,采用随机区组设计的方法分为5组,每组5个。实验组分别用100、150、200、250 W声功率HIFU对棘球蚴囊进行沿着囊壁多层面的环形照射,覆盖棘球蚴囊囊壁,层面间距为5 mm,每个层面沿囊壁环形扫描1遍,环形扫描速度为3 mm/s,扫描1次,照射时间2～10 min;对照组用普通超声照射2 min。以原头蚴的死亡率作为效应指标,同时检测囊液中乳酸脱氢酶、碱性磷酸酶活性。结果HIFU照射后棘球蚴的原头蚴急性死亡率显著升高(F=38.00,P<0.01),囊液内的乳酸脱氢酶活性显著升高(F=14.75,P<0.01),碱性磷酸酶活性显著升高(F=12.00,P<0.01)。结论HIFU沿棘球蚴囊壁多层面环形照射的方法对棘球蚴有损伤的效果。
Objective To explore the effect of high intensity focused ultrasound (HIFU) killing Echinococcus cysts. Methods Fresh goat liver infected with hydatid cyst was collected. Twenty-five hydatid cysts with diameter less than 50 mm and thin wall were selected. Echinococcosis cysts with diameter less than 50 mm were randomly divided into five groups (n = 5 each) . The experimental group were treated with 100, 150, 200, 250 W acoustical power HIFU respectively. Echinococcosis sacs were ring irradiated along the multilayered surface of the cyst wall, covering the cyst wall of hydatid cyst. The spacing was 5 mm. Wall ring scan 1 times, the ring scanning speed of 3 mm / s, scanning 1, irradiation time 2 ~ 10 min; control group with ordinary ultrasound irradiation 2 min. With the mortality of protoscolcoides as an effect index, the activity of lactate dehydrogenase and alkaline phosphatase in cyst fluid was also tested. Results The acute mortality of Echinococcus granulosus was significantly increased after HIFU irradiation (F = 38.00, P <0.01), and lactate dehydrogenase activity in cyst fluid was significantly increased (F = 14.75, P <0.01) Phosphatase activity was significantly increased (F = 12.00, P <0.01). Conclusion HIFU along the hydatid cyst wall annular irradiation method of hydatid cysts have the effect of injury.