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目的探索经皮超声波导入尿激酶消融兔颈动脉及其分支动脉粥样硬化斑块的疗效。方法兔动脉粥样硬化模型组分为自然消退组喂饲普通颗粒饲料;超声波组进行颈内动脉处超声波频率干预;超声波导入尿激酶组同单纯超声波组技术参数,在超声探头上的海面薄膜上加入5万IU/ml/个尿激酶;静脉给予尿激酶组由耳缘静脉推注尿激酶,10万IU/d。分别连续推注10d和20d。于干预后第10天和第20天处死动物,取材进行颈动脉彩色多普勒超声检查、血脂测定及颈动脉病理切片观察。结果超声波治疗10d组与20d组的血脂水平差异无统计学意义。超声波导入尿激酶20d组与10d组TG、LDL和HDL比较差异具有统计学意义,静脉给予尿激酶组差异亦具统计学意义(P<0.01)。超声波10d组、超声波导入尿激酶20d组斑块体积较其他各组明显减少(P<0.001)。超声波20d组管壁中膜最厚,斑块体积最大,与其他各组相比有统计学意义(P<0.001),但最大斑块虽占血管腔面积百分比并不是最大。最大斑块所占管腔面积百分比以静脉给予尿激酶10d、20d组最为严重,自然消退10d组和超声波10d组次之,超声波导入尿激酶组较轻。结论连续经皮超声导入尿激酶可缩小颈动脉软斑,降低斑块数目,减轻管腔狭窄程度,加快血流速度,改善脑缺血症状其疗效优于单纯超声治疗和静脉给予尿激酶的疗效。
Objective To investigate the efficacy of percutaneous transcutaneous ultrasound catheterization of urokinase in rabbit carotid artery and its branches atherosclerotic plaque. Methods The rabbit models of atherosclerosis were fed with normal pellet diet in the natural regression group. The ultrasound group was given the frequency of ultrasound at the internal carotid artery. The parameters of the ultrasound-guided urokinase group were compared with those of the pure ultrasound group. Add 50,000 IU / ml / urokinase; urokinase intravenous injection of urokinase from the ear vein, 100,000 IU / d. Respectively, continuous injection 10d and 20d. Animals were sacrificed on the 10th and 20th days after the intervention. The specimens were examined by color Doppler sonography, lipids and carotid pathological sections. Results Ultrasound treatment of 10d group and 20d group, there was no significant difference in the level of blood lipid. The differences of TG, LDL and HDL between the 20 d group and the 10 d group were statistically significant (P <0.01). The differences between the urokinase group and the 10 d group were also statistically significant (P <0.01). Ultrasound 10d group, ultrasound induced urokinase 20d plaque volume was significantly reduced compared with other groups (P <0.001). The thickness of the medial membrane in the 20-day ultrasound group was the thickest with the largest plaque volume, which was statistically significant compared with the other groups (P <0.001). However, the largest plaque area was not the largest in percentage of lumen area. The largest plaque area of the lumen percentage of intravenous administration of urokinase 10d, 20d the most serious group, spontaneous regression 10d group and ultrasound 10d group followed by ultrasound into the urokinase group lighter. CONCLUSION: Continuous percutaneous ultrasound can reduce the carotid soft spot, reduce the number of plaque, reduce the degree of stenosis, accelerate the blood flow velocity and improve cerebral ischemic symptoms. The curative effect is better than the simple ultrasound and intravenous administration of urokinase .