液态栓塞剂栓塞甲状腺动脉的可行性研究

Study of Embolizing Thyroid Anteries in Dogs with Liquid Embolization Agents in Treatment of Hyperthyroidism

目的 :探讨液态栓塞剂———平阳霉素碘油乳剂 (PLE)动脉栓塞治疗甲亢的可行性。方法 :1 8条杂种犬随机等分为 3组 ,分别使用TH胶、PLE及生理盐水 (NS)栓塞各组犬的双侧甲状腺上动脉 ,观察栓塞前、栓塞后不同时间 (7,1 4 ,2 1 ,2 8d)T3、T4、TSH及血钙水平的变化 ,栓塞后 1个月处死动物 ,取甲状腺及周边组织 ,应用HE染色观察栓塞后甲状腺病理形态的变化。结果 :除NS组外 ,PLE组及TH胶组术后不同时间与术前比较 ,T3、T4水平均呈明显的负相关下降 (P <0 .0 5 ) ,TSH水平均呈明显的正相关升高 (P <0 .0 5 ) ,该两组间比较 ,差异无显著性(P >0 .0 5 ) ,血钙水平各组术前术后差别无统计学意义 (P >0 .0 5 ) ;镜检发现PLE能闭塞甲状腺血管 ,甲状腺组织缺血灶性坏死 ,滤泡变性萎缩 ,间质纤维增生及淋巴细胞浸润 ,与TH胶所致的病理改变相似 ;而NS组甲状腺无明显改变。结论 :PLE栓塞甲状腺效果良好 ,安全简便 ,并发症少 。

Objective: To study the effects and safety of Pingyangmycin Lipiodol Emulsion(PLE) on embolization of thyroid anteries. Methods: Eighteen mongrel dogs were randomly divided into three groups: TH glue group, PLE group and NS group. Three different embolic agents were injected respectively into both anterior thyroid arteries of dogs in each group. Serum T3, T4, TSH and calcium was measured in different intervals during the experiment. After one month of arterial embolization, all the animals were killed. Morphological changes of the embolized thyroid gland were observed with HE staining. Results: Compared with NS group, the levels of T3, T4 were significantly reduced and TSH level was significantly increased at various time after the embolization in PLE group and TH group ( P< 0.05); and no difference was found between these two groups ( P >0.05). Meantime serum calcium level changed without significancy in all groups ( P >0.05). Pathological examination showed that PLE could obstruct the thyroid arteries and most of their microbranches. Chemical inflammation, necrosis, fibrosis and follicle atrophy were observed in embolized thyroid tissue, similar to pathological changes treated by TH glue. Conclusion: Pingyangmycin Lipiodol Emulsion(PLE), safe and effective in use without complication, is a potential peripheral embolization agent in interventional therapy of hyperthyroidism.