高强度聚焦超声对淋巴管的生物学效应

Biological effect of high intensity focused ultrasound on lymphatic vessels

目的用高强度聚焦超声（HIFU）辐照大鼠淋巴管，观察产生的生物学变化，探讨HIFU治疗乳糜尿的可行性。方法将SD大鼠32只随机均分为4组；用高强度聚焦超声辐照大鼠右侧腹股沟区，左侧对照；分别于辐照后24h、72h、7d、30d观察辐照区及周围组织肉眼及病理改变。结果HIFU辐照后，大鼠腹股沟淋巴管24h及72h组表现为管腔变形、破裂等急性损伤改变，7d及30d组表现为淋巴管数量减少、管腔闭塞、管周瘢痕形成；各时间组实验侧淋巴管密度（LVD）比自身对照侧明显减少：24h组为1．100±0．428比1．450±0．411（P〈0．01）；72h组为0．725±0．238比1．575±0．362（P〈0．01）；7d组为0．375±0．198比1．575±0．249（P〈0．01）；30d组为0．175±0．198比1．500±0．400（P〈0．01）；辐照后，随时间延长，实验侧LVD明显减少（F=16．669，P〈0．01）；辐照后7d，LVD减少不明显（P〉0．05）。结论高强度聚焦超声可靶向损伤淋巴管，最终使管腔粘连闭塞，因此高强度聚焦超声治疗乳糜尿有可行性。

Objective To investigate the use of high-intensity focused ultrasound （HIFU） to non- invasively produce biological effect in rat lymphatic vessels in vivo, and the feasibility of HIFU in the treatment of chyluria. Methods Thirty-two SD rats were divided into four groups randomly. The right inguinal regions were irradiated and the left served as controls. At the 1st, 3rd, 7th and 30 day after HIFU irradiation, the gross and pathological changes were observed. Resets There were acute changes such as the lymphatic vessels rupture and deformation on the experimental sides at Ist and 3rd day after HIFU irradia- tion. The number of lymphatic vessels was reduced, lumen was occluded, scar formed around the lumen at 7th and 30th day. The lymphatic vessec density （LVD） on the experimental side was significantly decreased as compared with the controls after HIFU irradiation （experimental sides vs controls： 1 st day, 1.100±0.428 vs 1.450±0.411 （P〈0.01）; 3rdday, 0.725±0.238 vs 1.575±0.362 （P〈0.01）; 7thday, 0.375±0.198 vs 1.575 ±0.249 （P〈0.01）; 30th day, 0.175±0.198 vs 1.500 ±0：400 （P 〈0.01）. There was a significant decrease in LVD on the experimental side with the time going （F = 16. 669 ,P 〈 0. 01 ）. However, there was no significant decrease in LVD at the 7th day （P 〉 0. 05 ）. Conclusion HIFU could precisely damage lymphatic vessels of rats and make lumen occlusion finally, suggesting the feasibility of HIFU for chyluria treatment.