超声弹性成像评价瘤内注射臭氧化盐水治疗兔VX-2瘤的效果

王凌霄 罗荣 蒋海波 宋禹杉 金修才 杨朝爱 杨继金

[摘要] 目的 運用超声弹性成像技术定量评价不同次数瘤内注射臭氧化盐水治疗兔VX-2瘤的效果。 方法 新西兰荷瘤大白兔48只，采用标签法随机分为4组。其中G0组12只注射1次低温生理盐水，实验组36只在超声引导下分别给予肿瘤体积2倍臭氧化生理盐水，并根据注射次数分为G1组（1次）、G2组（2次，1次/d）、G3组（3次，1次/d），每组各12只。分别于术前，术后4、8 d测量肿瘤的长径（a）、短径（b）和弹性值（B/A），根据公式V=1/2ab2计算各组肿瘤体积（V），并比较肿瘤生长率。 结果 G1、G3组术后4 d肿瘤生长率低于G0组，差异有统计学意义（P < 0.05）;G1、G2、G3组术后8 d肿瘤生长率低于G0组，差异有统计学意义（P < 0.05）。术后4 d，四组肿瘤组织弹性值比较，差异有统计学意义（P < 0.05）;其中，G1、G2、G3组兔VX-2瘤组织弹性值低于G0组，差异有统计学意义（P < 0.05）。术后8 d，四组肿瘤组织弹性值比较，差异有统计学意义（P < 0.05）;其中，G1、G2、G3组兔VX-2瘤组织弹性值低于G0组，且G2、G3组低于G1组，G3组低于G2组，差异有统计学意义（P < 0.05）。 结论 二维超声联合弹性成像技术，可以更客观、全面地评价不同次数瘤内注射相同浓度臭氧化盐水对兔VX-2瘤的治疗效果，且以多次治疗后肿瘤组织弹性值下降最明显。

[关键词] 臭氧;臭氧化水;超声弹性成像;VX-2瘤

[中图分类号] R735.7          [文献标识码] A          [文章编号] 1673-7210（2020）07（c）-0008-04

Effect of intraocular injection of ozonated saline on rabbit VX-2 tumor by evaluation of ultrasound elastography

WANG Lingxiao1   LUO Rong2   JIANG Haibo1   SONG Yushan1   JIN Xiucai1   YANG Chao′ai2   YANG Jijin2

1.Department of Ultrasound， Changhai Hospital， the Second Military Medical University， Shanghai   200433， China; 2.Department of Intervention， Changhai Hospital， the Second Military Medical University， Shanghai   200433， China

[Abstract] Objective To evaluate the effect of different times of intraocular injection of ozonized saline on VX-2 tumor in rabbits by ultrasound elastography. Methods A total of 48 New Zealand tumor-bearing white rabbits were randomly divided into four groups by labeling. Among them， 12 rabbits were in the G0 group （injected with low-temperature normal saline， once）， while 36 rabbits of the experimental group were given twice the volume of ozonized normal saline under ultrasound guidance， and according to the number of injections， they were divided into G1 （one time）， G2 （two times， once a day）， G3 group （three times， once a day）， with 12 rabbits in each group. The long diameter （a）， short diameter （b） and elasticity value （B/A） of the tumor were measured before operation， four and eight days after surgery. The tumor volume （V） was calculated by the formula V=1/2ab2 and tumor growth rate were compared. Results The tumor growth rate of the G1， G3 group four days after surgery were lower than that of the G0 group， and the differences were statistically significant （P < 0.05）; the tumor growth rate of G1， G2 and G3 groups were lower than that of the G0 group eight days after surgery， and the differences were statistically significant （P < 0.05）. Four days after surgery， the elasticity value of the tumor tissues in the four groups were statistically significant （P < 0.05）; among them， the elasticity value of the VX-2 tumor tissues in the G1， G2 and G3 groups were lower than that in the G0 group， and the differences were statistically significant （P < 0.05）. Eight days after surgery， the elasticity value of the tumor tissues in the four groups were statistically significant （P < 0.05）; among them， the elasticity value of the VX-2 tumor tissues in the G1， G2 and G3 groups were lower than that in the G0 group， while the G2 and G3 groups were lower than that in the G1 group， and G3 group was lower than G2 group， and the differences were statistically significant （P < 0.05）. Conclusion Two-dimensional ultrasound combined with elastography can more objectively and comprehensively evaluate the therapeutic effect of different times of intraocular injection of the same concentration of ozonated saline on rabbit VX-2 tumors， and the most obvious decrease in tumor tissue elasticity value after multiple treatments.

[Key words] Ozone; Ozonated water; Ultrasound elastography; VX-2 tumors

医用臭氧于20世纪初开始应用于医学，现已广泛应用于腰椎间盘突出症[1]、组织缺血再灌注等疾病的治疗[2]。19世纪80年代，臭氧治疗肿瘤的实验研究及作为临床恶性肿瘤治疗的辅助手段的报道逐渐出现[3-7]。有学者认为[8-9]，单独使用臭氧治疗恶性肿瘤可使肿瘤部分灭活，与化疗的效果相同。前期动物實验研究中，多采用CT或高频超声测量肿瘤大小，通过计算肿瘤生长率比较治疗效果。然而，瘤内注射臭氧对肿瘤治疗作用的早期，主要是对肿瘤细胞和血管的直接破坏，引起组织坏死和变性，在肿瘤体积发生变化前，组织弹性或许已发生变化。应力超声弹性成像技术[10]正是通过测定组织应变，并计算感兴趣区域与周围组织应变比值，从而判断该区域的组织硬度，可以较好地定量评价感兴趣区域的组织硬度。……