^(153)钐-柠檬酸-羟基磷灰石滑膜切除术的实验研究

Experimental study on radioisotope synovectomy with ^(153) -Sm-citrate HA

目的 研究153 钐柠檬酸羟基磷灰石 (153Sm citrate HA)局部应用对抗原诱导性关节炎的影响 ,为临床应用提供依据。方法 新西兰兔皮下注射鸡卵蛋白 ,2周、4周后分别重复注射 ,6周后关节腔注射鸡卵蛋白形成抗原诱导性对称关节炎。然后一侧关节分别注射153Sm citrate HA1 85× 10 7Bq或 3 7× 10 7Bq。关节炎以关节直径、关节表面皮肤温度、大体形态学和病理学来评估。结果 诱导后关节直径、表面温度大幅上升 (P <0 0 5 ) ,大体形态学和病理学见典型滑膜炎。注射153Sm(1 85× 10 7Bq)导致一过性炎症反应 ,7d后肿胀和局部发热缓解 ,并持续 36d。153Sm(3 7× 10 7Bq)同样有一过性炎症反应 ,7d后缓解 ,关节直径和皮肤温度较对侧关节有差异 (P <0 0 5 ) ,并一直持续至处死前未改变。而大体形态学和病理学可见滑膜炎减轻 ,其指标与对侧相比差异有显著性 (P <0 0 5 )。结论 关节腔注射一定剂量的153Sm citrate HA对滑膜炎出现有利效果 ,可作为治疗慢性关节炎的一种方法 。

Objective Effects of intra articular injection of 153 Sm citrate HA on antigen induced arthritis were investigated to provide the theoretical fundation for its clinical application.Methods Rabbit arthritis was induced by subcutaneous injection of ovalbumin at weeks 2 and 4,and by intra articular injection of it at week 6.The dosage of 1 85×10 7 Bq or 3 7×10 7 Bq of 153 Sm citrate HA was injected separately into a side of knee joint.The severity of arthritis was determined by joint swelling,skin surface temperature,macroscopic and histologic changes in joints when the rabbits were killed at week 9 after establishment of model.Results Both dosages of 153 Sm have an initial pro inflammatory effects during one week after injection,and then resulted in reduction of joint diameter and skin surface temperature. 153 Sm (3 7×10 7 Bq) showed a more alleviation than 153 Sm (1 85×10 7 Bq) in respect of macroscopic and histologic changes.Conclusion Synovectomy with 153 Sm citrate HA is effective for treatment of chronic arthritis with dependence on the doses and deserves further study.