超声空化效应破坏兔胶原诱导性关节炎滑膜血管翳的实验研究

Destruction of Synovial Pannus of Antigen-induced Arthritis by Ultrasonic Cavitation in Rabbits

目的探讨超声空化效应破坏兔胶原诱导关节炎滑膜血管翳的最适超声辐照及微泡条件。方法建立双侧兔膝关节胶原诱导关节炎模型(AIA模型),将85只造模成功兔随机分入不同超声峰值负压、不同脉冲宽度、不同脉冲重复频率、不同超声辐照时间、不同微泡浓度、不同辐照次数组,经兔耳缘静脉推注微泡Sonovue,同时超声辐照右侧膝关节,在超声辐照1d后处死,根据MRI及病理结果选出最适合的超声空化条件。结果超声空化效应破坏滑膜血管翳最适合的条件为间歇式超声辐照,间歇时间6s,超声峰值负压4.6MPa,脉冲宽度100cycles,脉冲重复频率50Hz,超声辐照时间5min,微泡浓度0.6mL/kg,多次超声辐照。辐照后右侧膝关节MRI显示滑膜厚度较左侧变薄,病理可见滑膜坏死。结论在适合的超声辐照及微泡浓度条件下,超声空化效应可破坏兔胶原诱导性关节炎滑膜血管翳。

Objective To optimize the conditions of ultrasonic irradiation and microbubble of ultrasound cavitation on destruction of synovial pannus of antigen-induced arthritis（AIA） in rabbits.Methods Antigen-induced arthritis was successfully induced on bilateral knee joints of 85 rabbits.Each 10 AIA rabbits were divided into two groups to compare various peak negative pressures,different ultrasonic pulse durations,various pulse repetition frequencies,different irradiance duration,different dosages of microbubble contrast agents,different ultrasonic irradiance times.With intravenous infusion of Sonovue to the rabbits,ultrasonic irradiance was performed on the right knee joint using the above condition of ultrasound cavitation.At the day 1 after ultrasonic irradiance,MRI and pathological examination were employed to evaluate the optimal conditions.Results The optimal parameters and conditions for ultrasonic irradiance included intermittent ultrasonic application（in 6 s intervals）,0.6 mL/kg of microbubble contrast agent,4.6 MPa of ultrasonic peak negative pressure,100 cycles of pulse duration,50 Hz of pulse repetition frequency,5 min of ultrasonic duration,0.6 mL/kg of dosages of microbubble contrast agents and multi-sessional ultrasonic irradiance.After the ultrasonic irradiance,the thickness of right knee synovium measured by MRI was thinner than that of left knee and synovial necrosis was confirmed by the pathological finding.Conclusion Under optimal ultrasonic irradiation and microbubble conditions,ultrasonic cavitation could destroy synovial pannus of AIA in rabbits.