三氧化二砷经肝动脉栓塞化疗对肝脏的毒副作用

目的　探讨As2 O3 经肝动脉栓塞化对肝脏的毒副作用及临床意义。方法　采用生理盐水 (实验组 1)、生理盐水 +碘化油 (实验组 2 )、As2 O3 +碘化油 (实验组 3 )经肝动脉注射治疗兔肝移植瘤一次 ,As2 O3 (实验组 4)经肝动脉插管灌注药物 ,连续 7d。观察瘤旁肝细胞、肝细胞线粒体的形态学变化并行线粒体比表面积定量分析、肝功能检测。结果　实验组 2、3肝细胞不同程度细胞体积增大、浊肿、甚至气球样变 ,实验组 4除肝细胞不同程度细胞体积增大、浊肿、气球样变外 ,还可见灶性坏死。实验组 3与实验组 4相比差异有显著性 (P <0 0 0 0 1) ,与实验组 2比差异无显著性 (P >0 0 5 )。肝细胞线粒体比表面积定量分析显示实验组 1、2、3、4肝细胞的线粒体比表面积逐渐缩小 ,差异具有显著性 ( P <0 0 5 ) ,同一实验组肝细胞线粒体比表面积与肿瘤细胞线粒体比表面积相比 ,同样具有差异性 (P <0 0 5 )。实验组 2、3、4肝功能指标中LDH、AST、ALT不同程度升高 ,实验组 2、3分别与实验组 1、4比较差异有显著性 (P <0 0 5 ) ;实验组 3与实验组 2比差异无显著性 (P >0 0 5 )。结论　As2 O3 经肝动脉栓塞化疗对兔肝细胞有一定的损伤作用 ,但程度轻于As2 O3 经肝动脉灌注治疗对肝脏的毒副作用。预示经肝动脉栓塞化疗是

Hepatic Toxicity of Arsenic Trioxide on Rabbits with Hepatic Vx-2 Carcinoma by Transcatheter Arterial Chemoembolization

Objective To evaluate hepatic toxicity of arsenic trioxide(As 2O 3) on rabbits with hepatic Vx-2 carcinoma by transcatheter arterial chemoembolization (TACE), and its clinical signification. Methods New Zealand rabbits with hepatic Vx-2 carcinoma were managed with normal saline (experimental group 1), normal saline plus lipiodol (experimental group 2), and As 2O 3 plus lipiodol (experimental group 3) respectively by TACE once, whereas experimental group 4 was treated with As 2O 3 by transcatheter arterial infusion(TAI) for 7 days consecutively. The morphological changes of the tumor adjancent hepatic tissue were observed under light microscope and transmission electron microscope. The hepatic function of the rabbits was also determined. Results The hepatic cells of the rabbits in the experimental groups 2 and 3 were injuried in various degrees, but the injury extent was smaller than that in the experimental group 4 (P<0.0001). The hepatic function of rabbits was damaged in experimental group 3, which was slighter than that in experimental group 4 (P<0.05). Conclusion As 2O 3 by TACE had a certain degree of hepatic toxicity, but its hepatic toxicity was smaller than that of As 2O 3 by TAI. The results suggested that TACE was a suitable appronch for treating advanced hepatic cell carcinoma, and at the same time it was necessary to protect hepatic function of the patients.