腺苷对兔溶栓后微循环障碍影响的实验研究  

The effect of adenosine on microcirculation disturbance after the thrombolysis therapy

作　　者：向凝[1] 李小鹰[1] 李金生[2] 

机构地区：[1]解放军总医院老年心内科,北京100853 [2]贵阳医学院附属医院心内科

出　　处：《中国康复医学杂志》2005年第9期656-659,T0002,共5页Chinese Journal of Rehabilitation Medicine

摘　　要：目的:观察溶栓后微循环再灌注和微血栓形成情况及腺苷对溶栓后微循环障碍的影响。方法:12只大耳白兔均用电刺激法在右股动脉形成稳定的闭塞性血栓,予尿激酶6万U/kg和肝素250U/kg静脉溶栓治疗,溶栓后随机分为腺苷治疗组(立即予腺苷0.3mg/min,静滴30min)和对照组(立即予等容量生理盐水静滴30min)。结果:用药后治疗组血浆6-酮-前列腺F1a(6-keto-PGF1a)与血栓素B2(TXB2)的比值(即P/T比值)明显高于对照组(电刺激前两组P/t比值差异无显著性意义,用药后治疗组为1.26±0.04,对照组为0.44±0.02,P<0.01);溶栓再通后治疗组肌腱微循环恢复情况较对照组好,无复流区域少;治疗组右胫前肌病理切片组织损伤轻且未见微血栓形成,而对照组可见微血栓形成。结论:溶栓后立即予腺苷治疗,可改善溶栓后的微循环障碍。Objective：To observe the influence of repeffusion on the microcireulation, the formation of microemboli and the protective effect of adenosine on the microcirculation disturbance after the thrombolysis therapy. Method： Twelve rabbits were divided randomly into two groups （6 rabbits for each）： adenosine group and control group. An occlusive thrombus was performed by using the direct electric current stimulation in the right femoral artery, then same doses of intravenous urokinase （60,000U/kg）and heparin （250U/kg）were used as thrombolysis therapy in both groups. In adenosine group,intravenous adenosine （0.3mg/min） was continuously administered for 30 min immediately after thrombolysis therapy,whereas control group received a comparable volume of normal saline.Result：The ratio of 6-Keto-PGF1a/TXB2 （P/T）in adenosine group was significantly higher than that in control group after medication （the ratio of P/T in adenosion group was 1.26±0.04,it was 0.44±0.02 in control group,P〈0.01）. The state of microcircu-ration was better, and the no-reflow phenomenon was less serious in adenosine group. Microthrombus was not discovered at the pathologic section of the right tibial muscle in the adenosine group, but in the control group there were microthromboli. Conclusion：Treatment with adenosine after thrombolysis can meliorate the microcirculation disturbances.

关 键 词：溶栓 腺苷 无复流现象 微血栓 

分 类 号：R543[医药卫生—心血管疾病]