大鼠肾上腺髓质增生的生物酶消融治疗

Biological enzyme ablation in the treatment of rat adrenal medulla hyperplasia

目的探讨生物酶消融利血平诱导的大鼠肾上腺髓质增生的治疗效果。方法雄性Wistar大鼠47只，皮下注射利血平建立大鼠肾上腺髓质增生模型。6周后随机取2只大鼠肾上腺行体外生物酶消融实验，其余45只大鼠随机分为A、B、C3组，每组15只。A组为生物酶消融组，将生物酶注入肾上腺；B组为D-Hanks液对照组；C组为正常对照组，不作任何处理。1个月后处死全部大鼠，观察治疗效果。结果在体外实验中，4h后生物酶可将肾上腺消融塌陷，髓质呈现空洞状，与对侧对比有显著变化。A组大鼠治疗后，肝肾功能无明显改变，肾上腺素、去甲肾上腺素及3-甲基4-羟基苦杏仁酸均有下降，治疗前分别为（2．36±0．48）nmol／L、（4．80±0．52）nmol／L、（8．43±1．03）mg／24h，治疗后分别为（1．10±0．12）nmol／L、（1．59±0．23）nmol／L、（2．67±0．38）mg／24h；肾上腺区塌陷，无明显粘连；肾上腺体积变小，失去正常的三角形或半月形；22侧肾上腺仅剩皮质，无明显髓质组织；8侧肾上腺髓质仅剩少许。B、C组鼠肾上腺仍维持增生状态。结论生物酶消融对于利血平诱导的大鼠肾上腺髓质增生有一定治疗作用，为临床上治疗肾上腺髓质增生提供了一种新的微创方法。

Objective To study the effect of biological enzyme ablation in the treatment of rat adrenal medulla hyperplasia induced by reserpine in vitro and in vivo. Methods Forty-seven mate Wistar rats were subcutaneously injected with reserpine （0.4 mg · kg^-1 · d^-1） and 0. 9% sodium chloride （0.4 mg·kg^-1·d^-1） for 6 weeks. In the 7th week,2 rats were randomly selected for experiment in vitro, adrenals were taken out and injected with biological enzyme, then watched for 3 or 4 h. The rest were randomly divided into 3 groups. Rats of group A were injected with biological enzyme; group B, D-Hanks; group C, normal control. Before treatment and 1 month after treatment, liver and kidney biochemistry, catecholamine（CA） concentration in serum and 3-methoxy-4-hydroxyvanillymandeic acid （VMA） concentration in urine were measured, in order to determine treatment effects. Pathological study was also done. Results In vitro experiments, biological enzyme ablated the adrenal medulla into cavity after 4 h. In vivo experiments, the values of VMA and CA in groups A were lower than that of before treatment（P〈0.05）,but the values of liver and kidney biochemistry were same with that of before treatment. Adrenal regions of group A were caved in and no obvious ad- herence, the adrenals were small and normal shape was lost. On the histology, adrenal medulla was almost lost and only the adrenal cortex remained after 1 month. While in group B and C, all the values did not change. The adrenal regions of group B and C were satiate and remained proliferation. Conclusions Reserpin can induce proliferation in rat adreanl medulla. Biological enzyme ablation has the definite effects in the treatment of adrenal medulla hyperplasia.