自制微铜圈栓塞兔肾动脉的效果研究

Renal artery embolization by use of self-made small copper coils: an experimental study in rabbits

目的:探讨自制微铜圈在实验兔体内的动脉栓塞效果和生物相容性。方法:将30只新西兰大耳白兔随机均分为实验组与对照组,分别用自制微铜圈(实验组)与Cook公司生产的微弹簧圈(对照组)经3 F微导管释放,栓塞兔肾动脉末梢支,于栓塞术后不同时间观察血管闭塞情况和病理学改变,同时对实验动物栓塞前后的实验室指标进行比较。结果:血管造影显示,栓塞后30 min,实验组血管栓塞的效果不如对照组(P<0.05),但栓塞后3 d至12周各时间点,两组血管栓塞效果差异无统计学意义(均P>0.05)。两组栓塞后肾脏大体病理学改变相似,血栓形成情况两组间差异无统计学意义(P>0.05),但实验组血管周围炎症反应较对照组轻(P<0.05)。栓塞术后,两组肝、肾功能指标变化差异无统计学意义(均P>0.05),且均在2周后恢复至术前水平;实验组血清铜离子术后2周内较术前升高(P<0.05),4周后恢复至术前水平(均P>0.05)。结论:自制微铜圈与微弹簧圈在动脉栓塞效果方面相似,且具有更好的生物相容性。

Objective： To assess the arterial embolic effect and biocompatibility of the self-made small copper coils in experimental rabbits.Methods： Thirty New Zealand white rabbits were equally randomized into experimental group and control group. The terminal branches of the renal artery of the rabbits were embolized using the self-made copper coils（experimental group） or spring microcoils（Cook Inc）（control group） via a 3-F microcatheter, respectively. The vessel occlusion status and pathological changes were observed at different times after the embolization, and the laboratory parameters of the experimental animals before and after embolization were compared.Results： Angiography showed that the embolic effect in experimental group was inferior to that in control groupat 30 min after embolization（P〈0.05）, but the embolic effect had no significant difference between the two groups at each time point from 3 d to 12 weeks after embolization（all P〉0.05）. After embolization, the renal gross morphological changes of the two groups were similar, and the thrombosis formation showed no significant difference between the two groups（P〉0.05）, but the perivascular inflammatory response in experimental group was milder than that in control group（P〈0.05）. After embolization, the changes in parameters of liver and renal function showed no significant difference between the two groups（all P〉0.05）, and 2 weeks later they all returned to pre-procedure levels; the serum copper level in experimental group was increased within 2 weeks compared with preoperative level（all P〈0.05）, but returned to preoperative level after 4 weeks（all P〉0.05）.Conclusion： Self-made small copper coils have similar arterial embolic effect as spring microcoils, and, in addition, has higher biocompatibility.