| 吴清华,周石,何玉洁,王学建.犬急性脑梗死动脉溶栓治疗时间窗的实验研究[J].中国医学影像技术,2006,22(7):1002~1005 |
| 犬急性脑梗死动脉溶栓治疗时间窗的实验研究 |
| Study on therapeutic time window of thrombolysis with urokinase in acute cerebral infarction in canine model |
| 投稿时间：2006-01-10 修订日期：2006-03-22 |
| DOI： |
| 中文关键词: 脑缺血 血栓溶解疗法 尿激酶 模型,动物 |
| 英文关键词:Brain ischemia Thrombolytic therapy Urokinase Models, animal |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨尿激酶动脉内溶栓治疗犬急性脑梗死的时间窗。方法 19条成年家犬随机分成A组(对照组)和B组(实验组),经股动脉插管注入血栓制作局灶性脑缺血动物模型,B组按溶栓时间分成B1、B3、B6、B9、B12组,分别在脑缺血后1、3、6、9、12 h经导管动脉注入尿激酶溶栓。行血管造影、磁共振扩散加权(DWI)扫描观察溶栓效果,并行犬神经功能评分。各组随机抽取1只于栓塞后24 h处死取脑行病理检查。结果 局灶脑缺血动物模型均成功建立, B1~B6组阻塞血管成功再通率为100%,B9组为66.7%,A组、B12组无再通;神经功能评分B1~B9组同A组 、B12组比较显著性差异(F=11.77, P<0.01)。DWI各组均出现高信号, 24 h梗死灶体积B1~B9组比较A组显著缩小(P<0.05)。B12组内1例并发颅内出血。病理:A组见大量神经元细胞坏死性改变,B组神经元细胞坏死程度较轻,残存细胞数目明显增多。结论 犬脑缺血6 h内尿激酶动脉溶栓疗效确定,6~9 h内动脉溶栓可以减少脑梗死体积比,延迟梗死体积扩大,12 h后动脉溶栓效果不明显。犬的动脉溶栓实用时间窗为9 h内。 |
| 英文摘要: |
| Objective To investigate the time window of urokinase(UK) thrombolysis in canine model with focal cerebral infarction. Methods Nineteen adult canines were all occluded with self-thromboses, then randomly divided into 6 groups. Group A was the control group (non-thrombolytic group). Group B1, B3, B6, B9 and B12 were given intra-arterial thrombolytic therapy with urokinase (10 000 IU/kg) at 1, 3, 6, 9, 12 hours after embolism respectively. Neurological deficit score was evaluated on the efficacy and safety of thromblysis therapy. Digital subtraction angiography and the axial diffusion-weighted images which used to measure the ischemic area in each animal at 1, 3, 6, 9, 12, 24 hours respectively were examined in all canines. One canine in every group was randomly selected to be executed pathologic examination. Results Infarction lesion appeared in every animal. The ratio of succesive recanalization in group B1, B3, B6 and B9 was 100%, 100%, 100%, 66.7% respectively. Neurological deficit score in group A, B12 was higher than group B1-B9(F=11.77, P<0.01). Significant differences on widening of infarction volume were observed between the group B1-B9 and group A (P<0.05). Encephalic hemorrhage occurred in one canine in group B12. Under light microscopy, the infarction tissure of control group showed lots of neuron necrosis. The ischemic cell damages in the therapeutic groups were alleviated and the number of remaining neurons increased. Conclusion Urokinase administered within 6 hours after ischemia is effective in reducing the ratio of infarction volume and can improve neurological status. When administered between 6 to 9 hours after ischemia, it may be helpful. When administered at 12 hours or more, it may be harmful. The study indicated that the practical therapeutic window of UK thrombolysis in acute infarction of canines is 9 hours. |
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