急性缺血性脑卒中尿激酶治疗剂量的动物实验研究  

An experimental investigation on the minimal effective dose of selective thrombolysis using urokinase in acute cerebral stroke in rabbit

作　　者：刘一之[1] 倪才方[1] 朱晓黎[1] 丁乙[1] 陈学仁[1] 王中[1] 周岱[1] 鲍耀东[1] 

机构地区：[1]苏州医学院附属第一医院放射科

出　　处：《中华放射学杂志》1998年第7期476-479,共4页Chinese Journal of Radiology

摘　　要：目的研究兔缺血性脑卒中起病后２４小时内经动脉灌注尿激酶治疗时，治疗时间与最小有效溶栓剂量之间的关系。方法２４只新西兰兔制成缺血性脑卒中模型，并分成四组（Ａ～Ｄ组），分别于起病后１、６、１２、２４小时行动脉内灌注尿激酶溶栓治疗，尿激酶注射速率为３２０Ｕ／ｓ，采用分割剂量，分段造影方法。各组随机抽取２只行病理学检查。以自身对照排除血栓自溶。结果（１）各组溶通率之间无显著性差异（Ｐ＞０．０５）。（２）起病后２４小时内溶栓所需的单位体重最小有效剂量随起病时间延长呈幂函数递增。实验所得的实际分布与理论分布重合很好。（３）病理检查证实：Ａ组未见梗死灶及出血灶；Ｂ组未见梗死灶，但１只脑干有小出血灶；Ｃ组和Ｄ组溶通者见小梗死灶，未见出血灶，未溶通者见大片梗死灶。结论（１）３２０Ｕ／ｓ的尿激酶动脉内灌注速率完全适用于兔缺血性脑卒中模型起病后２４小时内的选择性动脉内溶栓治疗。（２）兔缺血性脑卒中模型起病后２４小时内溶栓时间（Ｔ）与溶栓所需的最小有效剂量（Ｄ）之间存在幂函数关系，函数方程为Ｄ＝ＫＴ，其中Ｋ为一常数，数值近似等于４１３９．９６。Purpose To study the relationship between the minimal effective dose of urokinase and the time when the local intra arterial fibrinolysis (LIF) was performed within 24 hours after unilateral cerebral artery occlusion in rabbits. Methods Ischmic cerebral stroke model was established in 24 rabbits. The rabbits were divided into four groups A, B, C and D corresponding to the beginning time of LIF after onset 1, 6, 12 and 24 hours. The concentration of the UK solution was 8 000U/ml and the perfusion rate was 320U/s. Pre and post embolization angiogrophy was performed in every rabbit. Before LIF, angiography was done to rule out any self thrombolysis and after LIF, angiography was performed in order to control the procedure of LIF. 2 rabbits were chosen randomly from each group after LIF and examined by pathology. Results (1) LIF was successful in 23 rabbits and there was no significant difference of the rate of recanalization among the four groups ( P >0.05). (2) Within 24 hours after onset, the per kilogram minimal effective dose of UK changed as a power series with the lapse of time. (3) Pathology revealed that ① there was no infarction and bleeding in group A; ② there was no infarction and bleeding in one rabbit of group B but the other one had small bleeding in brain stem; ③ there was small infarction in group C and D rabbits after recanalization and there was a large infarction in the rabbit with failed LIF. Conclusion Within 24 hours after the ischemic cerebral stroke in rabbits, the per kilogram minimal effective dose of UK in LIF changes as a power series with elapse of time. The power function equation is D= K T . K is approximate to 4 139.96.

关 键 词：中风 脑栓塞 溶栓疗法 尿激酶 

分 类 号：R743.305[医药卫生—神经病学与精神病学]