中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2012年
10期
1006-1009
,共4页
朱绍芬%刘巍峰%程彩虹%刘巍松
硃紹芬%劉巍峰%程綵虹%劉巍鬆
주소분%류외봉%정채홍%류외송
经颅多普勒超声%脑梗死%尿激酶%超声微泡剂%血栓溶解
經顱多普勒超聲%腦梗死%尿激酶%超聲微泡劑%血栓溶解
경로다보륵초성%뇌경사%뇨격매%초성미포제%혈전용해
Tran-cranial Doppler ultrasound%Cerebral infarction%Urokinase%Microbubble%Thrombolysis
目的 评价经颅多普勒超声(TCD)监护下超声微泡剂辅助尿激酶溶栓治疗的有效性. 方法 将雄性新西兰大白兔32只按随机数字表法分为单用尿激酶组和尿激酶联合超声微泡剂组,每组各16只.采用兔颈外动脉插管注入自体血栓方法制备成大脑中动脉栓塞模型,并应用TCD监测血栓溶解过程.尿激酶联合超声微泡剂组静注尿激酶后立即静注六氟化硫超声微泡剂(声诺维).2组动物均在溶栓治疗后2h内持续TCD监测并记录溶栓治疗后不同时间点大脑中动脉血流动力学变化,并根据TCD频谱形态及血流速度判断血管再通情况. 结果 2组动物溶栓治疗前大脑中动脉的平均血流速度比较差异无统计学意义(P＞0.05).溶栓治疗后单用尿激酶组完全再通l例,部分再通4例,血管再通率为31.3％；尿激酶联合超声微泡剂组完全再通3例,部分再通6例,血管再通率为56.3％.2组动物病理检查均未见脑出血.单用尿激酶组梗死灶大小占梗死半球的百分率平均为13.9％,尿激酶联合超声微泡剂组梗死灶大小占梗死半球的百分率平均为9.1％,比较差异有统计学意义(P=0.025). 结论 TCD监测下应用超声微泡剂有助于增强尿激酶的溶栓治疗效果,初步证明TCD联合超声微泡剂可辅助尿激酶溶栓治疗脑梗死.
目的 評價經顱多普勒超聲(TCD)鑑護下超聲微泡劑輔助尿激酶溶栓治療的有效性. 方法 將雄性新西蘭大白兔32隻按隨機數字錶法分為單用尿激酶組和尿激酶聯閤超聲微泡劑組,每組各16隻.採用兔頸外動脈插管註入自體血栓方法製備成大腦中動脈栓塞模型,併應用TCD鑑測血栓溶解過程.尿激酶聯閤超聲微泡劑組靜註尿激酶後立即靜註六氟化硫超聲微泡劑(聲諾維).2組動物均在溶栓治療後2h內持續TCD鑑測併記錄溶栓治療後不同時間點大腦中動脈血流動力學變化,併根據TCD頻譜形態及血流速度判斷血管再通情況. 結果 2組動物溶栓治療前大腦中動脈的平均血流速度比較差異無統計學意義(P＞0.05).溶栓治療後單用尿激酶組完全再通l例,部分再通4例,血管再通率為31.3％；尿激酶聯閤超聲微泡劑組完全再通3例,部分再通6例,血管再通率為56.3％.2組動物病理檢查均未見腦齣血.單用尿激酶組梗死竈大小佔梗死半毬的百分率平均為13.9％,尿激酶聯閤超聲微泡劑組梗死竈大小佔梗死半毬的百分率平均為9.1％,比較差異有統計學意義(P=0.025). 結論 TCD鑑測下應用超聲微泡劑有助于增彊尿激酶的溶栓治療效果,初步證明TCD聯閤超聲微泡劑可輔助尿激酶溶栓治療腦梗死.
목적 평개경로다보륵초성(TCD)감호하초성미포제보조뇨격매용전치료적유효성. 방법 장웅성신서란대백토32지안수궤수자표법분위단용뇨격매조화뇨격매연합초성미포제조,매조각16지.채용토경외동맥삽관주입자체혈전방법제비성대뇌중동맥전새모형,병응용TCD감측혈전용해과정.뇨격매연합초성미포제조정주뇨격매후립즉정주륙불화류초성미포제(성낙유).2조동물균재용전치료후2h내지속TCD감측병기록용전치료후불동시간점대뇌중동맥혈류동역학변화,병근거TCD빈보형태급혈류속도판단혈관재통정황. 결과 2조동물용전치료전대뇌중동맥적평균혈류속도비교차이무통계학의의(P＞0.05).용전치료후단용뇨격매조완전재통l례,부분재통4례,혈관재통솔위31.3％；뇨격매연합초성미포제조완전재통3례,부분재통6례,혈관재통솔위56.3％.2조동물병리검사균미견뇌출혈.단용뇨격매조경사조대소점경사반구적백분솔평균위13.9％,뇨격매연합초성미포제조경사조대소점경사반구적백분솔평균위9.1％,비교차이유통계학의의(P=0.025). 결론 TCD감측하응용초성미포제유조우증강뇨격매적용전치료효과,초보증명TCD연합초성미포제가보조뇨격매용전치료뇌경사.
Objective To evaluate the efficacy ofmicrobubbles-assisted urokinase thrombolysis under transcranial Doppler ultrasound (TCD) in rabbits with cerebral infarctions.Methods Male New Zealand white rabbits (n=32) were randomly divided into two groups,a urokinase group and a combined urokinase and microbubble group (n=16).The middle cerebral artery (MCA) was occluded by injecting autologous blood clots through the carotid artery.In the combined urokinase and microbubble group,sulfur hexafluoride (SonoVue) microbubbles were injected intravenously immediately after intravenous injection of urokinase.The animals in these two groups were monitored by TCD within 2 h of thrombolysis,and the hemodynamic changes were recorded and the recanalization was noted according to the TCD spectral morphology and blood flow velocity.Results The average blood flow velocity of the middle cerebral artery before performing thrombolysis showed no significant difference between the 2 groups (P＜0.05).One rabbit in the urokinase group had complete recanalization and 4 partial mecanalization with a recanalization rate of 31.3％.Three rabbits in the combined urokinase and microbubble group had complete recanalization and 6 partial recanalization with a recanalization rate of 56.3％.Pathological examination showed no cerebral hemorrhage in either group.The average size of the infarction foci was 13.9％ in the urokinase group and 9.3％ in the combined urokinase and microbubble group with significant difference (P=0.025).Conclusion The addition of microbubbles to urokinase treatment increases vascular recanalization and decreases infarct size,and does not cause side effect of cerebral hemorrhage.During 2 MHz ultrasound monitoring,microbubble can assist urokinase thrombolysis for acute cerebral infarctions.
