低分子右旋糖酐对溶栓后再灌注微循环障碍作用研究  

An Experimental Study on the Protective Effect of Low Molecular Dextran to Microcirculation Disturbance after Thrombolysis in Rabbits

作　　者：陈添华[1] 李小鹰[2] 李金生[3] 

机构地区：[1]井冈山学院附属医院心内科 [2]中国人民解放军总医院老年心内科,北京100853 [3]贵阳医学院附院心内科,贵州贵阳550004

出　　处：《贵阳医学院学报》2006年第3期241-243,246,共4页Journal of Guiyang Medical College

摘　　要：目的：观察溶栓后再灌注微循环和微血栓形成情况及低分子右旋糖酐的治疗作用。方法：中国大耳白兔12只，体重2．5～3．0kg，随机分为生理盐水对照组和低分子右旋糖酐治疗组，每组6只。用电刺激法在兔右股动脉造成血栓，尿激酶和普通肝素溶栓后，对照组和治疗组立即分别给予生理盐水和低分子右旋糖酐静脉推注。通过对微循环、不同时间静脉血中血栓素（TXB2），和6-酮-前列腺素F1a（6-Keto-PC．Fla）含量，病理观察、评价对微循环及微血栓形成的影响。结果：对照组溶栓后出现明显无复流现象，治疗组无复流现象得到改善；对照组和治疗组再通后TXB2和6-Keto-PGF1a均升高，但治疗组6-Keto-PGF1a升高更显著，而对照组TXB2也明显升高；观察到对照组微血栓形成和明显组织损伤，治疗组未见微血栓形成，组织损伤较轻。结论：溶栓后立即给予低分子右旋糖酐可改善无复流现象，改善溶栓后微循环再灌注。Objective： To observe the influence of post-thrombolysis reperfusion on microcirculation and formation of microemboli in microvessels and to study the curative effect of dextran 40 on non-reflow symptoms. Methods： Twelve rabbits were randomly divided into two groups： group normal saline （ Group A） and Group dextran 40 （ Group B）. After being anesthetized, rabbit femoral artery thrombosis model was established with direct electricity stimulating. Urokinase （60000u · kg^-1 ） with heparin （250u · kg^-1） was given via vein, followed immediately by treatment via vein with normal saline in group A （5ml/kg^-1） and dextran 40 （5ml/kg^-1） in group B. The influence of dextran 40 on microcirculation and formation of microthrombi were observed by checking microcirculation changes, pathological changes, and levels of TXB2 and 6-Keto-PGFla at different time points in each group. Resuits： The non-reflow phenomenon was more serious in group A, and the non-reflow area was more extensive, while non-reflow area in group B was significantly smaller. Compared to group A, rabbits in group B had higher 6-Keto-PGF1α levels and lower TXB2 levels at different time points after reperfusion. The damage to the skeletal muscle was attenuated and no microthrombi were found in group B. Conclusions： Treatment with Dextran 40 immediately after the administration of urokinase could decrease the area of non-reflow after recanalization, therefore may improve the microcirculation reperfusion.

关 键 词：微循环 血栓形成 右旋糖苷类 再灌注 兔 

分 类 号：R543.31[医药卫生—心血管疾病] R331.35[医药卫生—内科学]