32P液体球囊血管内照射预防血管介入治疗后再狭窄的实验研究

目的观察血管内液体球囊放射治疗对血管介入治疗后再狭窄的影响，为其临床应用提供实验依据；同时通过放射治疗效应来探讨放射治疗防止再狭窄发生的可能机制。方法兔髂动脉经球囊过度扩张损伤后，一侧经３２Ｐ液体球囊血管内照射作治疗，另一侧未经治疗作对照。用计算机图像分析方法观察血管组织形态学的变化；免疫组化方法测定增殖细胞核抗原（ＰＣＮＡ）阳性细胞以了解血管内膜增殖过程。结果兔髂动脉经球囊过度扩张损伤后，血管内膜可明显增生，ＰＣＮＡ染色为强阳性；经３２Ｐ液体球囊照射后的对侧损伤髂动脉，内膜增生明显受抑，ＰＣＮＡ染色为弱阳性，外弹力板围绕面积均增加，管腔面积无明显变化。结论３２Ｐ液体球囊确可防止再狭窄的形成，其机制可能是通过抑制平滑肌细胞增殖和改善血管重塑形成。

Experimental study of endovascular brachytherapy using liquid 32 P filled balloon catheter

Objective To evaluate the effect of endovascular brachytherapy on restenosis after interveneional therapy and investigate the possible mechanism of restenosis prevention after endovascular brachytherapy. Methods In balloon injuried rabbit model, pathological sections of iliac artery were observed to estimate the changes of vascular histomorphology by computer analysis of photomicrogram and the proliferation of vascular smooth muscle cells was evaluated by means of immunohistochemistry to quantify the proliferation of cellular nuclear antigen(PCNA).Results After rabbit iliac arteries were injuried by balloon overstretch angioplasty, PCNA staining showed less proliferative in the irradiation side than in the control side. In the irradiation side, the fromation of neointima was suppressed, with EEL area increased but without lumen area change.Conclusion Endovascular brachytherapy using liquid 32 P filled balloon catheter system could prevent restenosis, its mechanism might be the inhibition on the proliferation of neointima and improvement on vascular remodeling.