超声造影剂及高吸水性树脂协同高强度聚焦超声杀伤细粒棘球蚴的研究

发布时间：2018-06-15 03:34

本文选题：高强度聚焦超声 + 超声造影剂　；参考：《重庆医科大学》2013年硕士论文

【摘要】：研究目的观察超声造影剂(ultrasound contrast agent, UCA)及高吸水性树脂(superabsorbent polymer, SAP)协同高强度聚焦超声(high intensityfocused ultrasound, HIFU)杀灭细粒棘球蚴的效果，探索UCA和SAP作为HIFU增效剂治疗包虫病的可行性。方法和结果从棘球蚴分离出原头节，选取活力为95%以上的原头节制成3000-5000个/ml的原头节悬液，将UCA加入悬液后进行HIFU辐照，通过对处理后原头节悬液温度和死亡率相关性进行了分析，发现HIFU功率一定时，单纯HIFU辐照使悬液温度增至（或接近）HIFU联用UCA辐照达到的温度需要更长的辐照时间，且此时单独使用HIFU辐照对原头节的杀伤效果不及后者。也就是说，UCA可增强HIFU的热效应和空化效应。其后，将SAP和UCA同时加入原头节悬液进行HIFU辐照，发现与单独加入UCA或SAP相比，二者合用的原头节悬液的超声图像灰度增强最为显著，原头节死亡率增加，且结构破坏更为严重。证实二者（SAP和UCA）联用对HIFU的增效作用最佳，可作为HIFU增效剂进行下一步试验。之后，选取圆形或类圆形、囊壁较薄且弹性良好的棘球蚴进行试验。将包囊按照不同的直径分组，将UCA注入棘球蚴包囊后进行HIFU辐照，发现HIFU辐照功率一定时，加入UCA能增加HIFU辐照包囊灰度变化和原头蚴的死亡率，并且该效果随UCA剂量的增加而加强。为探索UCA协同HIFU辐照对棘球蚴囊壁的损伤作用，选取15个直径为30mm左右的包囊随机分为3组：对照组，接受超声假照；单纯HIFU组，接受100W HIFU辐照；HIFU+UCA组，注入0.1ml UCA后进行HIFU辐照。辐照后观察超声图像的灰度变化和囊壁的肉眼变化，并取囊壁组织制作病理切片、扫描电镜切片和透射电镜切片，观察其病理改变。结果发现100W HIFU辐照可破坏囊壁的部分生发层和角质层；加入UCA后进行100W HIFU辐照，生发层几乎无残留，角质层也遭到更严重的破坏。UCA和SAP单独或联用均可使超声图像灰度增强，囊内原头节死亡率增加，结构破坏更为严重。将UCA或（和）SAP注入棘球蚴包囊后进行HIFU辐照，发现UCA和SAP单独或联用均可使超声图像灰度增强，囊内原头节死亡率增加，结构破坏更为严重，且UCA与SAP联合协同HIFU辐照时增效作用最为显著。囊壁的组织病理结果显示，HIFU对棘球蚴的生发层和角质层有一定的破坏作用，但仍有生发层残余；在联用UCA或（和）SAP后，囊壁的破坏加重，且联用时破坏效果最为显著，生发层消失，角质层也遭到严重的破坏。最后为了评估SAP和UCA与HIFU单独或联合使用后对体内棘球蚴的治疗效果。通过将从感染棘球蚴的羊肝分离出棘球蚴移植进入兔腹腔我们建立了兔移植棘球蚴模型，随后HIFU在SAP和UCA单独或联合协同下辐照兔移植模型体内的棘球蚴。结果表明HIFU对棘球蚴有如下效应：超声图像回声增强，原头节死亡率增加，原头节结构被严重破坏，在SAP和UCA与HIFU单独或联用组里可发现角质层遭到破坏，生发层被破坏甚至消失。覆盖棘球蚴区的兔皮的肉眼及病理学检查未见异常。结果表明兔棘球蚴移植模型可以作为HIFU治疗体内棘球蚴的理想模型，UCA和SAP可以被用来增强HIFU的辐照效果，并且证明HIFU在100W功率下是安全可行的对于辐照特殊动物模型体内的棘球蚴。结论 1.UCA联用HIFU可提高HIFU消融包虫原头节的热效应和空化效应，，可作为HIFU增效剂进行HIFU治疗包虫病的下一步试验； 2. SAP和UCA均可增强HIFU对离体原头节的杀伤效果，且二者联用时增效作用最佳； 3. UCA能增强HIFU对离体细粒棘球蚴治疗效率，提高对原头蚴的杀伤效果； 4. UCA能增强HIFU对离体细粒棘球蚴囊壁的破坏作用； 5. SAP和UCA均可增强HIFU对离体棘球蚴的杀伤效果，且二者联用时增效作用最佳； 6.棘球蚴家兔移植模型是观察HIFU对体内棘球蚴杀伤作用的理想模型； 7. UCA和SAP联用时可在不损伤兔皮的前提下增强HIFU对家兔体内棘球蚴的杀伤效果，可作为HIFU增效剂进行下一步试验。
[Abstract]:Purpose of study

Objective To investigate the efficacy of ultrasound contrast agent ( UCA ) and high water - absorbent resin ( SAP ) in killing Echinococcus granulosus by high intensity focused ultrasound ( HIFU ) .

Methods and Results

The results showed that the ultrasound image gray scale enhancement of HIFU combined with UCA was the most significant at this time . In other words , the combination of SAP and UCA could enhance the thermal effect and cavitation effect of HIFU .

In order to investigate the damage effect of UCA on the cyst wall of Echinococcus granulosus , 15 patients with diameter of 30 mm were randomly divided into 3 groups : the control group , the ultrasound false illumination was accepted ;
HIFU group received 100W HIFU irradiation ;
HIFU + UCA group was injected with 0.1 ml of UCA and HIFU was irradiated . After irradiation , the changes of gray scale of ultrasound image and gross change of capsule wall were observed . The pathological changes were observed by scanning electron microscope and transmission electron microscope . The results showed that 100W HIFU irradiation could destroy the partial hair layer and stratum corneum of the capsule wall .
UCA and SAP alone or in combination can increase the gray level of ultrasound image , increase the mortality rate of the original head and increase the structure damage .
After the combination of UCA or ( and ) SAP , the destruction of the capsule wall is aggravated , and the destruction effect is most remarkable when the combination is combined , and the hair growth layer disappears , and the stratum corneum is also severely damaged .

In order to evaluate the therapeutic effects of SAP and UCA alone or in combination with HIFU on Echinococcus granulosus in vivo .

Conclusion

1 . UCA combined HIFU can improve the thermal effect and cavitation effect of the original head of HIFU , and can be used as HIFU synergist for the next step of HIFU treatment .

2 . Both SAP and UCA could enhance the killing effect of HIFU on ex vivo original head , and the synergistic effect was the best when both were used .

3 . UCA can enhance the therapeutic efficiency of HIFU on Echinococcus granulosus in vitro , and improve the killing effect of HIFU .

4 . UCA can enhance the destruction of HIFU on the cyst wall of Echinococcus granulosus in vitro ;

5 . Both SAP and UCA could enhance the killing effect of HIFU on isolated Echinococcus granulosus .

6 . The transplantation model of Echinococcus granulosus is an ideal model to observe the killing effect of HIFU on Echinococcus granulosus in vivo ;

7 . When UCA and SAP are used together , the killing effect of HIFU on Echinococcus granulosus in rabbits can be enhanced without damaging the rabbit skin , and can be used as HIFU synergist for the next step .
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R532.32

【参考文献】