CAJ | 학술논문

目的：观察血管腔内放疗对经皮腔内冠状动脉成形术(PTCA)后再狭窄的防治作用。方法：选用家兔经颈外动脉插管对其颈总动脉实行了PTCA，术后给予血管腔内放疗(核通后装治疗计划)，放射源中心轴外3mm为处方剂量点，分别照射10Gy、20Gy和30Gy。术后4、12、24周取颈总动脉行病理检查。结果：对照组PTCA后4周，可见管腔狭窄，内膜不规则增厚，新生内膜内见大量棱形平滑肌细胞，排列紊乱，部分内弹力膜断裂。10Gy剂量放疗组未见有新生内膜，管腔无狭窄，内弹力膜完整，管壁略变薄。20Gy或30Gy放疗组管腔变大，管壁明显变薄，胶原组织和平滑肌细胞数量减少。12周的病理结果与24周时无明显差异。结论：血管腔内放射治疗可明显抑制血管损伤后的组织增生，且抑制程度与剂量相关。
목적：관찰혈관강내방료대경피강내관상동맥성형술(PTCA)후재협착적방치작용。방법：선용가토경경외동맥삽관대기경총동맥실행료PTCA，술후급여혈관강내방료(핵통후장치료계화)，방사원중심축외3mm위처방제량점，분별조사10Gy、20Gy화30Gy。술후4、12、24주취경총동맥행병리검사。결과：대조조PTCA후4주，가견관강협착，내막불규칙증후，신생내막내견대량릉형평활기세포，배렬문란，부분내탄력막단렬。10Gy제량방료조미견유신생내막，관강무협착，내탄력막완정，관벽략변박。20Gy혹30Gy방료조관강변대，관벽명현변박，효원조직화평활기세포수량감소。12주적병리결과여24주시무명현차이。결론：혈관강내방사치료가명현억제혈관손상후적조직증생，차억제정도여제량상관。
Objective:To investigate the inhibit effect of hyperplasia of theendovascular brachytherapy for the restenosis after percutaneous transluminal coronary angioplasty(PTCA). Method:Endovascular brachytherapy with nucletron afterloder and plato TPS had been used at external carotid artery in a rabbit post-PTCA restenosis model and 10, 20 and 30 Gy had been delivered to the point 3 mm from the axis of the source.Pathologic examination of the external carotid artery had been performed at 4, 12 and 24 weeks after PTCA. Result:A reduction of luminal area with marked fibrocellular neointimal hyperplasia, a disordered arrangement of fusiformed smooth muscle cells and part of the internal elastic membrane fragmentation were noted 4 weeks after PTCA in the control group. Neither fibrocellular neointimal hyperplasia nor reduction of luminal area was found in the 10 Gy treatment group. A slight asymmetric thinning of media was noted in the same group. The luminal area was increased, and thinning of media was evident with a marked reduction in smooth muscle cells and in collagen tissue,in the 20 Gy and 30 Gy treatment groups. There was no evident difference in histological examination between 12 weeks and 24 weeks. Conclusion:Intracavity radiotherapy can inhibit neointimal proliferation in the post-PTCA restenosis model and the effect is associated with the dose.