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泌尿系统中的热疗法:阿累尼乌斯模型与热等效剂量模型在预测热损伤方面的比较

Thermal therapy in urologic systems: a comparison of arrhenius and thermal isoeffective dose models in predicting hyperthermic injury.

作者信息

He Xiaoming, Bhowmick Sankha, Bischof John C

机构信息

Department of Mechanical Engineering, and Biomedical Engineering Program, University of South Carolina, Columbia, SC 29208, USA.

出版信息

J Biomech Eng. 2009 Jul;131(7):074507. doi: 10.1115/1.3128671.

Abstract

The Arrhenius and thermal isoeffective dose (TID) models are the two most commonly used models for predicting hyperthermic injury. The TID model is essentially derived from the Arrhenius model, but due to a variety of assumptions and simplifications now leads to different predictions, particularly at temperatures higher than 50 degrees C. In the present study, the two models are compared and their appropriateness tested for predicting hyperthermic injury in both the traditional hyperthermia (usually, 43-50 degrees C) and thermal surgery (or thermal therapy/thermal ablation, usually, >50 degrees C) regime. The kinetic parameters of thermal injury in both models were obtained from the literature (or literature data), tabulated, and analyzed for various prostate and kidney systems. It was found that the kinetic parameters vary widely, and were particularly dependent on the cell or tissue type, injury assay used, and the time when the injury assessment was performed. In order to compare the capability of the two models for thermal injury prediction, thermal thresholds for complete killing (i.e., 99% cell or tissue injury) were predicted using the models in two important urologic systems, viz., the benign prostatic hyperplasia tissue and the normal porcine kidney tissue. The predictions of the two models matched well at temperatures below 50 degrees C. At higher temperatures, however, the thermal thresholds predicted using the TID model with a constant R value of 0.5, the value commonly used in the traditional hyperthermia literature, are much lower than those predicted using the Arrhenius model. This suggests that traditional use of the TID model (i.e., R=0.5) is inappropriate for predicting hyperthermic injury in the thermal surgery regime (>50 degrees C). Finally, the time-temperature relationships for complete killing (i.e., 99% injury) were calculated and analyzed using the Arrhenius model for the various prostate and kidney systems.

摘要

阿伦尼乌斯模型和热等效剂量(TID)模型是预测热损伤最常用的两种模型。TID模型本质上是从阿伦尼乌斯模型推导而来,但由于各种假设和简化,现在导致了不同的预测结果,特别是在温度高于50摄氏度时。在本研究中,对这两种模型进行了比较,并测试了它们在传统热疗(通常为43 - 50摄氏度)和热手术(或热疗法/热消融,通常大于50摄氏度)中预测热损伤的适用性。两种模型中热损伤的动力学参数均从文献(或文献数据)中获取,制成表格,并针对各种前列腺和肾脏系统进行分析。结果发现,动力学参数差异很大,并且特别依赖于细胞或组织类型、所使用的损伤检测方法以及进行损伤评估的时间。为了比较这两种模型预测热损伤的能力,使用这两种模型在两个重要的泌尿系统,即良性前列腺增生组织和正常猪肾组织中预测了完全杀伤(即99%细胞或组织损伤)的热阈值。在温度低于50摄氏度时,两种模型的预测结果吻合良好。然而,在较高温度下,使用传统热疗文献中常用的恒定R值0.5的TID模型预测的热阈值,远低于使用阿伦尼乌斯模型预测的热阈值。这表明传统使用TID模型(即R = 0.5)不适用于预测热手术(大于50摄氏度)中的热损伤。最后,使用阿伦尼乌斯模型计算并分析了各种前列腺和肾脏系统完全杀伤(即99%损伤)的时间 - 温度关系。

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