组织型纤维蛋白溶解酶原激活剂缺失突变体治疗兔视网膜静脉阻塞的疗效  

The thrombolytic effect of reteplase in treating rabbit retinal vein occlusion

作　　者：翁欢[1] 李秋华[1] 张瑞帆[2] 

机构地区：[1]复旦大学附属华山医院眼科,上海200040 [2]四川省人民医院眼科,成都610072

出　　处：《复旦学报（医学版）》2009年第5期549-552,共4页Fudan University Journal of Medical Sciences

基　　金：上海市经委课题(沪创新J-59-3)

摘　　要：目的在兔视网膜静脉阻塞(retinal vein occlusion,RVO)模型上研究组织型纤维蛋白溶解酶原激活剂缺失突变体(reteplase,r-PA)的溶栓效果,并与重组人组织型纤维蛋白溶解酶原激活剂(recombinant tissue-type plasminogen activator,rt-PA)对照,评价两种溶栓药物在静脉应用的疗效。方法光化学法诱导45只兔RVO模型(45只眼),分别静脉注射r-PA(15只眼)、rt-PA(15只眼)和注射用水(15只眼,对照组),4 h后观察血管再通情况,检测溶栓相关血液指标。结果给药后4h,r-PA组与rt-PA组静脉完全再通率分别为77.33%和为66.67%,无统计学意义;两者与对照组比较,完全再通率有统计学意义(P<0.001)。在给药后rt-PA组血浆凝血酶时间较r-PA组延长,血浆纤维蛋白原较r-PA组下降,且有统计学意义。结论静脉注射r-PA对兔RVO模型有治疗效果,疗效与rt-PA无明显区别,r-PA对凝血和纤溶系统的影响比rt-PA小。Objective To study the thrombolytic effect of intravenous administration of r-PA and compare it with rt-PA in the treatment of experimental rabbit retinal vein occlusion （ROV） models. Methods The animal models of RVO in 45 rabbits （45 eyes） were achieved by photochemical method and then r-PA（15 eyes）, rt-PA（15 eyes） or water（as control, 15eyes）were injected through the marginal ear vein of rabbits respectively. The direct ophthalmoscopy and FFA were performed four hours after the injection and the reperfusion of the vein was observed. The changes of fibrinolitic activities in the blood were also examined. Results The complete reperfusion rates four hours after intravenous administration of r-PA and rt-PA were 73. 33 % and 66. 67%, which had no statistical difference,and both were significantly increased compared with the control group （P〈0. 001 ）. In rt-PA group, the TT is longer and Fbg is lower compared with r-PA group. Conclusions Both r-PA and rt-PA can treat RVO effectively, and there is no obvious difference between them. Compared with rt-PA, r-PA has less influence on the cruor system and fibrinolysis system.

关 键 词：视网膜静脉阻塞 组织型纤维蛋白溶解酶原激活剂缺失突变体 重组人组织型纤维蛋白溶解酶原激活剂 

分 类 号：R774.1[医药卫生—眼科]