^99Tc^m-SZ-51对兔骨水泥髓腔灌注后肺血栓形成及其干预措施的放射免疫显像研究

Radioimmunoimaging study of pulmonary artery thrombi in rabbits with ^99Tc^m -SZ-51 after bone cement perfusion and intervention

目的应用^99Tc^m-SZ-51检测骨水泥灌注后兔肺血栓的形成，并探讨预防肺栓塞发生的干预措施。方法大耳白兔16只，体重2．5～3．okg，随机分为4组。A组（未干预组）：骨髓腔灌注骨水泥并加压；B组（盐酸肾上腺素组）：骨髓腔内用盐酸肾上腺素盐水（1：10000）冲洗髓腔后灌注骨水泥并加压；C组（生物蛋白胶组）：用生物蛋白胶喷洒骨髓腔后灌注骨水泥并加压；D组（空白对照组）：骨髓腔不灌注骨水泥。每组动物在骨水泥灌注前耳缘静脉注入吼“^99Tc^m-SZ-51 2ml，骨水泥灌注后60、120和180min进行核素显像，测定活体肺放射活性后，立即处死动物，取出完整肺组织，测定离体肺放射活性后肺组织固定进行病理学检测。结果骨水泥髓腔灌注并加压后60、120和180min，肺组织的放射活性，A组分别为（11．48±2．35）、（14．41±3．10）和（18．25±5．01）ID／pixels，B组分别为（8．21±3．21）、（10．19±2．40）和（11．32±3．12）ID／pixels，C组分别为（4．06±1．04）、（5．68±2．80）和（7．40±1．12）ID／pixels，各时间点组问差异有统计学意义。病理学检查显示肺部有血栓形成，骨水泥髓腔灌注前应用盐酸肾上腺素或生物蛋白胶，肺部放射活性明显下降。结论^99Tc^m-SZ-51可以用于骨水泥灌注后兔肺血栓形成的动态观察。应用盐酸肾上腺素和生物蛋白胶可以降低骨水泥肺栓塞的发生率。

Objective To detect pulmonary artery thrombosis with ^99Tc^m -SZ-51 in rabbits after cement perfusion, and to discuss the ways of preventing pulmonary artery thrombus. Methods Sixteen rabbits （weight 2.5-3.0 kg）were randomly divided into 4 groups： group A （no intervention group）, bone cement perfusion into madullary cavity and compression; group B （adrenalin hydrochloride group）, pretreat the madullary cavity with adrenalin hydrochloride （1：10 000）, and then bone cement perfusion and compression; group C （fibrin sealant group）, pretreat the madullary cavity with fibrin sealant, and then bone cement perfusion and compression; group D （control group）, no bone cement perfusion. ^99Tc^m -SZ-51 was injected through ear marginal vein for 2 ml before perfusing bone cement. The radioactivity of lung was measured in vivo af- ter perfusing 60,120 and 180 min. Then the rabbit were killed and its lung was harvested. The radioactivity was measured in vitro and the pathological examination was done. Results After perfusion 60, 120 and 180 min, the radioactivities of lung were （11.48＋2.35）, （14.41-＋3.10）, （18.25±5.01） ID/pixels in the group A, （8.21±3.21）, （10.19±2.40）, （11.32±3.12） ID/pixels in the group B, （4.06±1.04）, （5.68±2.80）, （7.40±1.12） ID/ pixels in the group C, respectively. The difference among groups was statistically significant. Pulmonary artery thrombus had been found in group A, B and C, but not in group D. Pretreatment with adrenalin hy- drochloride and fibrin sealant, the radioactivity of lung was significantly decreased. Conclusion ^99Tc^m -SZ-51 can be used in the observation of pulmonary artery thrombus formation after bone cement perfusion in rabbit. Pretreatment with adrenalin hydrochloride and fibrin sealant before bone cement peffusion can significantly lower the risk of pulmonary artery thrombus.