Chinese Journal of Tissue Engineering Research ›› 2013, Vol. 17 ›› Issue (12): 2091-2099.doi: 10.3969/j.issn.2095-4344.2013.12.001
Self-made Fe3O4 versus gelatin sponge embolic agents in rabbit pulmonary microcirculation
Yang Qing, Tong Yu-yun, Guo Li, Wang Jia-ping, Li Ying-chun, Jiang Hua
- Department of Interventional Radiology, Second Hospital of Kunming Medical University, Kunming 650101, Yunnan Province, China
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Received:2012-12-12Revised:2013-02-05Online:2013-03-19Published:2013-04-27 -
Contact:Tong Yu-yun, Master, Attending physician, Department of Interventional Radiology, Second Hospital of Kunming Medical University, Kunming 650101, Yunnan Province, China 1012580@qq.com -
About author:Yang Qing☆, Doctor, Attending physician, Department of Interventional Radiology, Second Hospital of Kunming Medical University, Kunming 650101, Yunnan Province, China yq7119@hotmail.com
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Yang Qing, Tong Yu-yun, Guo Li, Wang Jia-ping, Li Ying-chun, Jiang Hua. Self-made Fe3O4 versus gelatin sponge embolic agents in rabbit pulmonary microcirculation[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(12): 2091-2099.
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2.1 实验动物数量分析 实验共用兔21只，其中1只行肺血管铸型，实验过程中死亡12只，死亡兔经解剖排除与异位栓塞相关，死因与麻醉过量、感染相关，及时补充实验兔达实验组规定数目，栓塞成功，最终计入结果分析兔共20只。 2.2 Fe3O4微粒体外形态 Fe3O4微粒加入碘化油中，初期微粒聚集呈大小不等团块沉于碘化油底部。充分振荡后，磁微粒团块离散，微粒呈均匀、分散状悬浮于碘化油中，然后缓慢沉降。用注射器推注可顺利通过直径为3-6F的动脉导管。5种规格及不同比例的Fe3O4微粒在碘化油中的悬浮情况见表1。5种Fe3O4微粒在各自沉降10%，20%，30%，50%，80%，100%的平均沉降时间和平均沉降速度间差异有显著性意义(P < 0.001)。"
2.3 正常兔肾动脉造影表现及血管铸型 每只实验用兔在栓塞前，经兔耳缘静脉行右心室造影，双侧肺动脉均无狭窄、闭塞、畸形等异常表现，血管铸型在解剖显微镜下能观察到细小血管，见图5。应用计算机病理图像定量分析同样方法，测量兔肺动脉第四五级分支直径在[368±42.5E (SEM=0.23)] μm兔肺静脉第四五级分支直径在[467±62.5E (SEM=0.26)] μm。"
2.4 实验兔栓塞后胸部X射线平片、数字减影血管造影复查结果 兔栓塞后1，2，4周，胸部X射线平片未见异常征像，见图6。"
数字减影血管造影复查：Fe3O4微粒栓塞组：栓塞后1，2，4周，栓塞后血管缺损区未见恢复，未见血管侧支形成。明胶海绵自制颗粒1栓塞组：栓塞后1，2周栓塞后血管缺损区未见恢复，未见血管侧支形成。第4周栓塞后血管缺损区部分再通，未见血管侧支形成。明胶海绵自制颗粒2栓塞组：栓塞后第1周栓塞后血管缺损区未见恢复，未见血管侧支形成。第2周栓塞后血管缺损区部分再通，部分血管侧支形成。第4周栓塞后血管缺损大部分再通。见表2。"
栓塞后5 min数字减影血管造影造影结果显示，Fe3O4微粒栓塞组均显示实验动物兔肺动脉主干存留，部分肺动脉分支消失，血流中断，兔无明显异常表现。明胶海绵自制颗粒1栓塞组均显示实验动物兔肺动脉主干存留，超选择栓塞肺动脉分支消失，血流中断，兔无明显异常表现。明胶海绵自制颗粒2栓塞组显示实验动物兔肺动脉主干存留，超选择栓塞动脉分支消失，血流中断，兔无明显异常表现，栓塞后1-4周造影复查，见图7。"
2.5 实验兔栓塞后1，2，4周肺组织病理分析结果 大体观察结果：Fe3O4微粒栓塞组兔肺栓塞后1周(2只)，栓塞肺脏体积变小，颜色暗红，被栓塞的肺段充血明显。2周(2只)、4周(6只)，栓塞肺脏，表面有散在出血点，质地变韧，实质出现梗死区域，梗死区与正常肺质分界清楚。明胶海绵自制颗粒1栓塞组兔栓塞肺动脉后1周(1只) ，栓塞肺体积稍增大，颜色深红，2周时(1只)，栓塞肺体积肺恢复正常，未见有明显梗死区域。4周时(2只)，仍未见有明显梗死改变。明胶海绵自制颗粒2栓塞组兔栓塞肺动脉后1周(1只)栓塞肺体积稍增大，颜色正常，2周时(1只)，栓塞肺体积肺恢复正常，未见有明显梗死区域。4周时(2只)，仍未见有明显梗死改变。见图8。"
光镜下兔肺栓塞组织病理改变：见表3。"
Fe3O4微粒栓塞组兔肺栓塞后1，2，4周，苏木精-伊红染色示50-250 μm的Fe3O4微粒：黑色Fe3O4微粒栓塞肺细小血管内，在较大血管中颗粒互相集聚成团，较小血管中偶可见单颗粒，各组颗粒栓塞血管程度不同，50 μm组栓塞可见少量位于肺泡周毛细血管及毛细血管前小动脉，多数集聚于小动脉内，栓塞彻底。100 μm粒径很少栓塞毛细血管，常五六个视野内未见栓塞毛细血管，毛细血管前小动脉见栓塞，多数集聚于5级分支小动脉内，150-250 μm栓塞范围在小动脉四五级小动脉内。明胶海绵自制颗粒1栓塞组兔栓塞肺动脉后1周(1只)，可见3级大动脉及4级小动脉内栓塞剂栓塞，远端小动脉未见栓塞。明胶海绵自制颗粒2栓塞组基本与明胶海绵自制颗粒1栓塞组相同。Fe3O4微粒栓塞组可见局部组织坏死，其他两组未见异常。见图9。"
50 μm粒径Fe3O4微粒能栓塞直径50-500 μm的毛细血管及毛细血管前小动脉，多集中在直径100- 200 μm血管范围里；100-200 μm Fe3O4微粒能栓塞直径150-700 μm毛细血管前小动脉，多集中在直径200-400 μm的毛细血管前小动脉范围里，250 μm Fe3O4能栓塞直径250-1 500 μm小动脉，多集中在350-700 μm的小动脉范围里。明胶海绵颗粒1 能栓塞(1 300±348) μm小动脉，明胶海绵颗粒2能栓塞 (1 263±436) μm小动脉。各种粒径Fe3O4微粒间差距有显著性意义(P < 0.05)。"
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