博莱霉素冷冻消融增效作用的试验研究

[目的]通过体内试验探讨博莱霉素的冷冻消融增效作用。[方法]12只杂种家犬B超引导氩氦刀冷冻消融肝脏，然后静脉注射低剂量和常规剂量^131Ⅰ标记的博莱霉素，测定博莱霉素在肝脏不同部位的分布情况，研究比较各组动物肝脏消融灶大小和病理变化。[结果]术后3h单纯冷冻组（A组）、冷冻＋低剂量博莱霉素组（B组）和冷冻＋常规剂量博莱霉素组（C组）肝脏消融灶体积差异不显著（P〉0．05）。而术后第1d、3d、5d观察，均发现后两组肝脏消融灶体积均显著大于单纯冷冻组（P〈0．01），5d后三组消融体积分别为：13．44±0．7cm^3，18．84±1．5cm^3和19．78±2．2cm^3（B、C组与A组比较，P〈0．01；B组与C组比较，P〉0．05）。[结论]冷冻治疗可增加博莱霉素的细胞渗透率，冷冻术后较低浓度博莱霉素即有细胞毒性作用，冷冻联合博莱霉素具有增效作用。

An Experimental Study on Synergistic Effect of Cryoablation Combined with Bleomycin

[Purpose ] To investigate synergistic effect of cryoablation combined with bleomycin in vivo. [Methods] Twelve mongrel dogs underwent B-type ultrasound guided liver cryoablation followed by intravenously ^131Ⅰ-labled bleomycin. Distribution of bleomycin in liver was detected. The volumes of cryoablation and the pathological changes were studied. [Results] The volume of cryoablation had no difference at 3 hours after treatment in cryoablation group （group A）; in cryoablation＋low dosage of bleomycin group（group B） and in routine dosage of bleomycin group（group C） （P〉0.05）, while the volume of cryoablation at 1 day, 3 days or 5 days after treatment was significantly greater in group B and group C and than that in group A. The volume of cryoablation in A,B and C group at 5 days after treatment was 13.44± 0.7cm^3,18.84±1.5cm^3 and 19.78±2.2cm^3 respectively （group B and group C compared to group A： P〈0.01; group B compared to group C： P〉0.05）. [Conclusion] Cryotherapy facilitates bleomycin penetrating into cells cytotoxic effect is revealed in lower dose bleomycin after cryoablation. Cryoablation combined with bleomycin has synergistic effect.