CAJ | 학술논문

目的观察低浓度α-氰基丙烯酸正丁酯(NBCA)经肝动脉栓塞兔肝脏肿瘤的可行性、安全性和有效性.方法 24只实验兔,开腹在肝脏左叶种植瘤细胞建立VX2肝脏肿瘤模型,建模后14 d CT扫描测量肿瘤大小,并用数字表法随机等分为3组,后通过肝动脉对肿瘤进行栓塞.A组为空白对照组,B组为超液化碘油组,C组为2.5% NBCA组.肝脏损害通过检测血清丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST)评价.栓塞术后第7天再次通过CT扫描测量肿瘤体积,肿瘤生长比率(术后7 d肿瘤体积与术前肿瘤体积之比);并于栓塞治疗后记录各组实验兔的生存时间.对ALT和AST采用重复测量方差分析,肿瘤生长比率和生存时间采用单因素方差分析比较.结果所有动物模型均成功建立并插管治疗.A、B、C各组实验兔在栓塞前后不同时间ALT和AST均值的差异有统计学意义(ALT的 F值分别为10.508、16.443、19.828,AST 的F值分别为23.696、23.334、15.594,P值均＜0.05).栓塞治疗后第4天A、B、C组ALT水平分别为(49.4±13.5)、(115.2±48.8)、(124.7±49.4)U/L,AST水平分别为(52.3±12.0)、(128.3±50.1)、(137.0±66.9)U/L,B组和C组血清ALT和AST水平均较A组高(P值均＜0.05).B、C组术后第4天ALT、AST均较术前明显升高(P值均＜0.05).各组ALT和AST术后第7天和术前相比,差异均无统计学意义.术后第7天肝脏肿瘤生长比率在3组之间差异有统计学意义(F=110.865,P=0.000);C 组的肿瘤生长比率为(0.839±0.144)%,显著低于A 组的(2.978±0.547)%(P=0.000),与B组的(0.871±0.073)%相比差异无统计学意义(P=0.845).栓塞治疗后C组生存期为(38.9±4.0) d,明显长于A组的(32.1±3.1) d(P=0.006);与B组的(36.9±4.8)d相比差异无统计学意义(P=0.366).结论经肝动脉栓塞低浓度NBCA治疗兔VX2肝脏肿瘤是一种可行的、安全的治疗方法,为治疗肝脏肿瘤提供一种新的选择,可能有潜在的临床推广价值.
목적 관찰저농도α-청기병희산정정지(NBCA)경간동맥전새토간장종류적가행성、안전성화유효성.방법 24지실험토,개복재간장좌협충식류세포건립VX2간장종류모형,건모후14 d CT소묘측량종류대소,병용수자표법수궤등분위3조,후통과간동맥대종류진행전새.A조위공백대조조,B조위초액화전유조,C조위2.5% NBCA조.간장손해통과검측혈청병안산전안매(ALT)화천동안산전안매(AST)평개.전새술후제7천재차통과CT소묘측량종류체적,종류생장비솔(술후7 d종류체적여술전종류체적지비);병우전새치료후기록각조실험토적생존시간.대ALT화AST채용중복측량방차분석,종류생장비솔화생존시간채용단인소방차분석비교.결과 소유동물모형균성공건립병삽관치료.A、B、C각조실험토재전새전후불동시간ALT화AST균치적차이유통계학의의(ALT적 F치분별위10.508、16.443、19.828,AST 적F치분별위23.696、23.334、15.594,P치균＜0.05).전새치료후제4천A、B、C조ALT수평분별위(49.4±13.5)、(115.2±48.8)、(124.7±49.4)U/L,AST수평분별위(52.3±12.0)、(128.3±50.1)、(137.0±66.9)U/L,B조화C조혈청ALT화AST수평균교A조고(P치균＜0.05).B、C조술후제4천ALT、AST균교술전명현승고(P치균＜0.05).각조ALT화AST술후제7천화술전상비,차이균무통계학의의.술후제7천간장종류생장비솔재3조지간차이유통계학의의(F=110.865,P=0.000);C 조적종류생장비솔위(0.839±0.144)%,현저저우A 조적(2.978±0.547)%(P=0.000),여B조적(0.871±0.073)%상비차이무통계학의의(P=0.845).전새치료후C조생존기위(38.9±4.0) d,명현장우A조적(32.1±3.1) d(P=0.006);여B조적(36.9±4.8)d상비차이무통계학의의(P=0.366).결론 경간동맥전새저농도NBCA치료토VX2간장종류시일충가행적、안전적치료방법,위치료간장종류제공일충신적선택,가능유잠재적림상추엄개치.
Objective To investigate the feasibility, safety and efficacy of transarterial embolization with low concentration of n-butyl cyanoacrylate(NBCA) in rabbit VX2 liver tumor models. MethodsTwenty-four rabbits were implanted with VX2 hepatic tumors into the left hepatic lobes, and were scanned with CT to measure the volume of the tumor after 14 days. They were randomly divided into three groups with 8 rabbits assigned to each group. Transarterial embolization was conducted with physiological saline in control group A, with pure Lipiodol in group B, with 2.5% NBCA in group C. Hepatic toxicity was evaluated by blood biochemical analysis of the plasma alanine aminotransferase (ALT) and aspartate aminotransferase (AST). One week later, the volumes of the tumors were measured by CT again. Tumor growth rate was the ratio of tumor's volume at 7th day after embolization to the tumors' volume before embolization. The survival periods of the rabbits of the three groups after treatment were also recorded. The data of ALT and AST mean values from each group were analyzed with repeated measurement analysis of variance (ANOVA). Tumor growth rates and survival periods were analyzed by using one-way ANOVA. Results All animal models were successfully established and underwent interventional catheterization. Both ALT and AST mean values of the rabbits in group A, B and C at each time point before and after embolization were significantly different (ALT F=10.508, 16.443, 19.828, respectively; AST F=23.696, 23.334, 15.594, respectively)(P＜0.05). ALT in group A, B, C were (49.4±13.5), (115.2±48.8), (124.7±49.4)U/L, while AST in group A, B, C were (52.3±12.0), (128.3±50.1), (137.0±66.9)U/L 4 days after embolization. The ALT and AST mean values were significantly elevated 4 days after embolization in group B and group C compared with those before embolization and those of group A 4 days after treatment(P＜0.05). However, the ALT and AST mean values showed no statistically significant difference in all the groups before embolization and 7 days after embolization. On the other hand, the growth rates of the tumors differed significantly among the three groups(F=110.865, P=0.000). The group C showed significantly lower tumor growth rate (0.839±0.144)% than the group A(2.978±0.547)%(P=0.000), but no significantly different tumor growth rate compared with group B(0.871±0.0725)%( P=0.845). Consequently, the survival period of the animals in group C(38.9±4.0) days was significantly longer than that in group A(32.1±3.1)days (P=0.006), while it was not significantly different from that in group B(36.9±4.8)days(P=0.366). ConclusionsTransarterial embolization with low concentration of NBCA was feasible and safe. It could be a new option of treatment for HCC and might have potential further clinical value.