1%聚桂醇在成人血管畸形治疗中的应用研究

Application of 1% lauromacrogol sclerotherapy on adult vascular malformations

目的探讨1%聚桂醇瘤体内注射治疗成人血管畸形的效果及作用机制。方法将28例成人血管畸形病例分成4组,术前注射治疗的时间分别为对照组、30 min、48 h、2周,选择1%聚桂醇注射治疗,采用组织化学法和免疫组织化学法观察收集到的瘤体标本,并测定血管内皮生长因子(VEGF)和CD34的含量。结果组织化学法光镜下见未用药组与各用药组之间组织结构无显著的差别,免疫组织化学法见VEGF、CD34在未用药组中表达呈强阳性,且表达的强度随着聚桂醇治疗时间的延长呈下降趋势,用药组各个时段间比较差异有统计学意义(P<0.05)。结论对于成人血管畸形的治疗,1%聚桂醇瘤体内注射是一种安全有效的治疗方法,推测其作用机制可能是通过下调VEGF、CD34的表达,破坏内皮细胞,栓塞病变血管,从而达到治疗效果。

Objective To investigate the clinical effect and mechanism of 1% lauromacrogol sclerotherapy on aduh vascular malformations. Methods 28 patients of adult vascular malformations were divided averagely into 4 groups. The control group received no therapy. The experimental groups received sclerotherapy 30 min, 48 h and 2 weeks respectively before the operation. The tissue structure of above examples was observed by histoehemistry method and the expression levels of the VEGF and MVD were detected by immunohistochemistry method. Results There were no significant difference between experimental groups and the control group in the specimen dyed by HE-staining. While the expressions of the VEGF and MVD were suppressed in the experimental groups by the means of immunohistochemistry. The variance was significant in all experimental groups. Conclusion Intratumoral injection of lauromacrogol for adult vascular malformations is safe and effective. The mechanism of the therapy may involve to suppress the experrssions of VEGF and MVD, induce the destruction of vascular endothelial cell, and promote the regression of the tumor.