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目的观察不同超声频率联合携尿激酶的靶向微泡造影剂对兔股动脉血栓的溶解作用,探讨影响溶栓作用的主要因素,寻找微循环再栓塞的相关指标。材料与方法 72只新西兰大白兔制作单侧股动脉血栓模型,按照完全随机分组方法分为12组,每组6只。根据超声频率(1.6、2.2、2.8 MHz)、超声照射时间(30、60 min)、尿激酶剂量(3、6 mg)3因素不同水平进行实验组合。靶向微泡携带尿激酶在低频超声辅助照射下溶栓,观察血管的溶通情况,并通过HE染色证实有无微循环再栓塞。抽取兔血检测6-酮-前列腺素Fla(6-keto-PGF1a)、血栓素B2(TXB2)、P/T比值(6-keto-PGF1a/TXB2)及P-选择素(SP)等指标。结果超声频率2.2 MHz、超声照射时间30 min、尿激酶剂量3 mg组血管全部溶通且无微栓塞发生;其余各组均有未溶通或合并微循环再栓塞发生的情况。溶栓后无微栓塞组的兔6-keto-PGF1a含量明显升高,差异有统计学意义(P<0.05);而其他指标差异无统计学意义(P>0.05)。结论超声频率2.2 MHz、超声照射时间30 min、尿激酶低剂量3 mg的条件下溶栓可实现血管的完全溶通。超声频率、超声照射时间及尿激酶剂量一定时可有效溶解血栓,但在溶栓的过程中可能会发生微循环的再栓塞。6-keto-PGF1a含量的升高对降低微循环再栓塞具有一定作用。
OBJECTIVE: To observe the dissolution of femoral artery thrombosis in rabbits with different ultrasound frequency combined with urokinase-targeted microbubble contrast agent and to explore the main factors influencing the thrombolytic effect and to find the relevant indexes of microcirculation re-embolization. Materials and Methods 72 New Zealand white rabbits were made unilateral femoral artery thrombosis model, divided into 12 groups according to a completely randomized grouping method, 6 in each group. The experimental combinations were performed at different levels of ultrasound frequency (1.6,2.2,2.8 MHz), ultrasound irradiation time (30,60 min) and urokinase dosage (3,6 mg). Microbubbles carrying urokinase in low-frequency ultrasound-assisted thrombolysis, observation of vascular permeability, and confirmed by HE staining with no microcirculation re-embolization. The serum levels of 6-keto-PGF1a, TXB2, P / T ratio (6-keto-PGF1a / TXB2) and P-selectin (SP) Results Ultrasound frequency of 2.2 MHz, ultrasonic irradiation time of 30 min, urokinase dose 3 mg group of vessels completely dissolved and no micro-embolism occurred; the rest of the groups were dissolved or combined microcirculation re-embolization occurred. After thrombolysis, the content of 6-keto-PGF1a in rabbits without micro-embolization group was significantly increased (P <0.05), while there was no significant difference in other indexes (P> 0.05). Conclusion Thrombolysis can be achieved by thrombolysis under the condition of 2.2 MHz ultrasonic frequency, 30 min ultrasonic irradiation and 3 mg urokinase. Ultrasound frequency, ultrasound irradiation time and urokinase dose can effectively dissolve thrombus, but in the process of thrombolysis may occur microcirculation re-embolization. Increased 6-keto-PGF1a may play a role in reducing microcirculation re-embolization.