碘油-聚乳酸微球栓塞兔肾动脉的实验研究

Experimental research of rabbit renal artery embolism with lipiodol-polylactic acid microspheres

目的通过兔肾动脉栓塞实验研究碘油-聚乳酸(LP-PLA)微球的X线可视性、栓塞效果及生物相容性。方法新西兰大白兔36只随机分为LP-PLA微球(LP-PLA)组和聚乙烯醇颗粒(PVA)组,栓塞后1、4、12周两组随机选取6只大白兔行肾动脉造影,后再对比双肾组织病理学差异,并明确栓塞前后相关指标的变化。结果透视下可观察到LPPLA微球的行程,栓塞术后1周栓塞材料仍显影;栓塞后1、4、12周造影两组均未见肾段动脉再通。两组栓塞后1周栓塞侧肾重量均较健侧肾显著增加(P<0.05),栓塞后4、12周栓塞侧肾均明显萎缩,健侧肾均代偿性增大,明显重于栓塞侧肾(P<0.05)。两组栓塞侧肾病理特点与血栓形成、机化相似;LP-PLA组栓塞动脉周围的异物巨细胞及炎症较PVA组明显。结论碘油-聚乳酸微球具有良好的X线可视性及组织相容性,并且其远期栓塞效果与PVA相似。

Objective To evaluate the radiopacity, embolic effect and biocompatibility of lipiodol polylactic acid （LP- PLA） microspheres in the setting of rabbit renal artery embolism. Methods Totally 36 healthy mature New Zealand white rabbits were randomly divided into two groups： LP-PLA group （left renal artery embolism by LP-PLA microspheres） and PVA group （left renal artery embolism by PVA particles）. Six big white rabbits in each group were randomly selected to perform the radiography, and blood routine and biochemistry tests （including hepatic and renal function） were measured at 1, 4 and 12 weeks after embolism. Pathological features on the left and right kidney were compared. Results LP-PLA microspheres mixing with normal saline could pass the pipe smoothly and its track under fluoroscopy monitor could be observed 1 week after embolism. Renal arteries were hot recanalized by angiography in each group at 1, 4 and 12 weeks after embolism. In both groups, the weight of the embolic kidney were significantly increased, compared with that of the healthy kidney at 1 week after embolism （P〈0.05） ; the embolic kidneys obviously atrophied and the healthy kidneys showed compensatory hypertrophy at 4, 12 weeks after embolism （P〈0.05）. The pathology of embolic kidneys showed thrombogenesis and organization, and the foreign body giant cells and inflammation reactions around the embolic artery in LP-PLA group were more obvious than those in PVA group. Conclusion LP-PLA microspheres demonstrate good radiopacity as well as histocompatibility in animal experiment, and it also shares similar long-time embolic effect with PVA.