家猪EUS引导下^125I放射性粒子腹腔神经节照射的损伤效果评价

Endoscopic ultrasound guided ^125I seeds placement for celiac ganglion brachytherapy in porcine models

目的观察EUS引导下^125I放射性粒子腹腔神经节照射对神经元的影响。方法12只家猪随机分成A、B、C3组，在静脉麻醉后行EUS引导下粒子双侧植入。A组种植空粒子；B组种植放射活度为0．4mCi[1．48×10^7Bq）的^125I粒子；C组种植放射活度为0．8mCi（2．96×10^7Bq）的^125I粒子，术后预防性使用抗生素并行CT增强扫描及血管三维重建，分别观察14d和60d后取腹腔神经节行TUNEL染色观察神经元坏死凋亡情况。结果10只家猪一次性种植成功，另外2只种植失败，隔日再行种植均成功。与对照组相比，^125I组可见神经元凋亡增加，并随照射剂量及照射时间呈正相关。结论内照射可诱导腹腔神经节细胞坏死凋亡，为该新方法的临床应用提供了理论依据。

Objective To evaluate the influence of brachytherapy with ^125I seeds on celiac ganglia in porcine models. Methods Twelve pigs were randomly assigned into 3 groups to accept celiac plexus block by bilateral injection with 2 non-radioactive seeds in group A （n = 4）, 0.4 mCi seeds in Group B （n = 4） and 0. 8 mCi seeds in Group C （ n = 4）, respectively. Prophylactic antibiotics were administered postoperatively. Enhanced CT and three-dimensional reconstruction of blood vessels were performed to confirm the proper placement of the seeds. The animals were sacrificed 14 days and 60 days after the procedure, and TUNEL assay was employed to study neuron apoptosis in celiac ganglia. Results The procedure was successfully performed in .10 pigs（ 83.3% ）and failed in two others. The rescue procedure was performed on the day after and succeeded in both pigs. Apoptosis of neurons significantly increased in brachytherapy groups than in the control group and it was positively correlated with dose and time of radiation. Conclusion Brachytherapy can cause apoptosis of neurons of celiac ganglion, which could be the basis of its clinical application.