TACE联合内皮抑素对兔VX2肝移植瘤的血流动力学影响的超声评价

目的 利用多普勒超声研究TACE联合内皮抑素栓塞治疗后兔VX2肝移植瘤及肝脏的血流动力学变化。方法 20只荷瘤兔，随机分为对照组和抗血管生成组，每组10只，抗血管生成组经兔肝动脉给予内皮抑素＋超液化碘油＋阿霉素栓塞治疗，对照组以生理盐水代替。1周后多普勒超声观察肿瘤血供及肝动脉、门静脉血流动力学变化，检测结果与治疗前相应血管的多普勒血流参数进行比较。结果 对照组治疗后肝动脉最大血流速度增大（P〈0．05），肝动脉阻力指数和门静脉血流速度无明显变化（P〉0．05）；抗血管生成组栓塞后肝动脉血流速度明显降低（P〈0．05），阻力指数增大（P〈0．05），门静脉血流速度无明显变化（P〈0．05）。治疗前所有病灶内及其周边多普勒超声均可检测出较丰富血流信号，治疗后显示抗血管生成组瘤内及瘤周血流信号均明显减弱，部分消失。结论 TACE联合内皮抑素可有效地阻断兔VX2肝移植瘤供血，多普勒超声可显示该血流的变化，便于对其疗效进行及时评价。

The effect of TACE with endostatin on hemodynamics in hepatic implantation tumor using Doppler ultrasonography

Objective To investigate the hemodynamic changes in the rabbit liver and VX2 hepatic implantation tumor after treatment by transcatheter arterial chemoembolization （TACE） / endostatin using Doppler uhrasonography. Methods Twenty rabbits with VX2 hepatic tumor were randomly distributed into the control group （n=10） and the anti-angiogenesis group （n=10）. The rabbits were administered with endostatin and adriamycin-lipiodol in the anti-angiogenesis group and with 37℃ saline in the control group via hepatic artery. The hemodynamic changes of the tumors, hepatic artery, and portal vein were recorded with Doppler ultrasonography 1 week after the treatment. The results before and after the treatment were compared. Results In the control group, the maximal hepatic artery blood flow velocity was significantly higher than that before the treatment（P〈0.05）. However, the resistance index and the portal vein blood flow velocities had no significantly change compared with those before the treatment （P〉0.05）. In the anti-angiogenesis group, the hepatic artery blood flow velocity was significantly lower than that before the treatment （P〈0.05）, and the resistance index was increased （P〈0.05）. However, the portal vein blood flow velocity had no significantly change （P〉0.05）. The blood flow signal in all tumors was rich before embolization. After TACE, the blood flow signal was significantly decreased, even partly disappeared in the anti-angiogenesis group. Conclusion TACE with endostatin can effectively block the blood supplement of VX2 hepatic implantation tumor. Doppler ultrasonography can detected the blood flow changes and can be used in evaluating the therapeutic effect in hepatic implantation tumor.