DSA引导下注射聚多卡醇和鱼肝油酸钠硬化剂对比格犬隐静脉的影响

Effect of DSA-guided injection of polidocanol and sodium morrhuate sclerosing agent on saphenous vein in Beagle Dogs

目的:比较DSA引导下注射两种常用泡沫硬化剂聚多卡醇和鱼肝油酸钠对比格犬下肢隐静脉血管璧的组织学损伤。方法:成年健康比格犬12只,随机分为聚多卡醇组和鱼肝油酸钠组,每组6只。DSA透视下行隐静脉造影,聚多卡醇组于左前、左后、右后肢注射1%聚多卡醇泡沫硬化剂,鱼肝油酸钠组于左前、左后、右后肢注射5%鱼肝油酸钠泡沫硬化剂。注射后30min、2d及28d,采集隐静脉标本进行HE和Massion染色,光镜下对比观察犬隐静脉血管壁内皮及中膜的组织学变化。结果:两种泡沫硬化剂均可致犬隐静脉血管内皮损伤和中膜增厚;注射后30min,两组病理上均可见内皮细胞部分丢失,中膜层平滑肌增厚,组织学未见明显差异;注射后2d,聚多卡醇组的中膜损伤率高于鱼肝油酸钠组[(63.6±9.4)%vs.(49.2±4.4)%],差异有统计学意义(P<0.05)。注射后28d,两组的内皮细胞完全脱落,中膜层平滑肌增厚,甚至延伸至外膜。聚多卡醇组血管壁内皮脱失率随时间延长无明显变化,中膜厚度随时间延长增大,鱼肝油酸钠组血管壁内皮脱失率随时间延长而加重,中膜厚度随时间延长增大。结论:聚多卡醇和鱼肝油酸钠均可对血管内皮和中膜造成损伤,长期对血管作用均产生胶原纤维化,聚多卡醇对血管产生纤维化的作用较鱼肝油酸钠大。

Objective: To compare the histological injury on the inferior saphenous vein of Beagle dogs after DSA-guided injection of two commonly used foam sclerosing agents, such as polycacol and sodium cod liver oil. Methods: Twelve Beagle dogs were selected and randomly devided into group A(polidocanol foam injection group) and group B (sodium morrhuat foam injection group), n=6. DSA fluoroscopy was performed on the saphenous venography. The 1% polydocaine foam sclerosing agent was injected into the left anterior, left posterior and right hind limbs, and 5% cod liver foam sclerosing agent was injected into the left anterior, left posterior and right hind limbs. Saphenous veins were removed after 30 min, 2 d and 28 d of injection and stained by HE or Massion. The histological changes of endothelium and medial membrane of saphenous vein were observed under light microscope. Results: Both foam hardeners could cause vascular endothelial injury and thickening of the medial membrane of the wall of canine saphenous vein. After 30 min, the partial loss of endothelial cells and thickening of smooth muscle in the middle layer were observed in both groups, and no significant histological difference was found between the two groups. After 2 d, the membrane damage rate in group A was higher than that in group B[(63.6±9.4)% vs.(49.2±4.4)%],and the difference was statistically significant(P<0.05). After 28 d, the endothelial cells of groups A and B were completely exfoliated, and the smooth muscle of the middle layer was thickened and even extended to the outer membrane, with no significant histological difference. There was no significant change in vascular endothelial injury in group A with the extension of time, while the thickness of the median increased with the extension of time;in group B, the vascular endothelial injury increased with the extension of time, and the thickness of the median increased with the extension of time. Conclusions: Both polydodecol and sodium ovalerate can cause endothelial and terminal damage to vascular walls, and produce collagen fibrosis. The effect of polydodecol on vascular fibrosis is greater than sodium.