^(32)P-玻璃微球肝动脉栓塞对肝组织损伤的实验评估

valuation of radiation damage of transcatheter hepatic arterial embolization using phosphorus 32 glass microspheresin aswine model

目的 研究正常家猪对３２Ｐ玻璃微球（３２ＰＧＭＳ）肝动脉内栓塞后内放射性的急性和亚急性毒性反应，探讨３２ＰＧＭＳ的临床应用安全性和使用安全剂量范围。方法 １０ 只正常家猪分为两组，实验组５ 只，对照组５ 只。分别用直径４６ ～７６ μｍ 的３２ＰＧＭＳ和３１ＰＧＭＳ作肝动脉栓塞。术后行血常规、肝肾功能等实验室检查，同时，行肝区和其他器官放射剂量分布等监测。术后１ 、２、４、８ 、１６ 周分别处死猪，行光学显微镜（ 简称光镜） 和电子显微镜（简称电镜）检查。结果 ３２ＰＧＭＳ均匀分布于给药动脉营养的全肝或肝叶内，达汇管区肝最小动脉水平，实验室及病理均显示肝组织有轻微的损伤，但均为一过性，约在８ 周左右恢复正常。肝组织损伤的超微结构改变以１～２ 周内最明显。实验组所接受的３２ＰＧＭＳ宏观平均吸收剂量为４８～１９０ Ｇｙ。结论 用３２ＰＧＭＳ行肝动脉栓塞为一有效、安全、可行的方法。

Objective To evaluatethe acuteand sub acutetoxicresponsetotranscatheterhepatic arterial emolization of Phosphorus 32 glass microspheres (32P GMS) in pigs- Methods Selective transcatheter hepatic arterialembolization was performedin10 healthy domestic pigsusing 46 -76 μm 32P GMS(5 pigs,48- 190 Gy) and nonradioactiveglass microspheres(5 pigs) ascontrolgroup- Bloodtestsincludingcomplete bloodcount,liver and kidneyfunctiontestswere measured- The distribution of32Pwas monitored- The pigs weresacrificedat1 ,2 ,4, 8 and16 weeks,respectively- Microscopicand ultrastructuralhistopathologyoftheliverand kidney wasevaluated- Results 32 P GMS was distributed evenly over the liver purfused- The GMS were located in the hepatic micrioarteriesandfew collateralfeeding arteries wereformed- Transientelevation oftransaminases wasobservedin allpigs following 32P GMSadministration- No evidence of myelosuppression was found- Swelling and vacuolar degeneration ofhepatocytesandlymphocyteinfiltrationintheliver were demonstratedinthe pigsinjected with 32P GMS- However,no hepatic parenchymal necrosis occurred- Conclusions This study suggests thatintraarterial hepatic administration of32P GMSwith doselessthan190 Gyis welltolerated-