尿激酶RGDS微泡在体溶栓的血流频谱特点与可能机制的实验研究  

Analysis of flow spectrum change and possible mechanism of using urokinase and glycoprotein Ⅱb/Ⅲa-targeted microbubbles prepared by direct conjugation method to dissolve the thromb in vivo

作　　者：关丽娜[1] 穆玉明[1] 王春梅[1] 郭朝峰[1] 

机构地区：[1]新疆医科大学第一附属医院超声医学中心心脏超声诊断科,乌鲁木齐830054

出　　处：《中华超声影像学杂志》2010年第11期997-1000,共4页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金（30860267）

摘　　要：目的 用直接连接法制备的携尿激酶RGDS超声微泡溶解在体血栓,分析其血流频谱的特征性改变及可能的溶栓机制.方法 42只新西兰大白兔单侧股动脉制成富含血小板的混合性血栓模型,分成7组,每组6只：①单纯超声照射组（US）;②超声照射＋造影剂注射组（US＋M）;③单纯尿激酶静脉注射组（UK）;④超声照射＋微泡造影剂＋尿激酶静脉注射组（US＋M＋UK）;⑤超声照射＋RGDS微泡造影剂组（US＋R）;⑥RGDS微泡造影剂＋尿激酶静脉注射组（R＋UK）;⑦超声照射＋RGDS微泡造影剂＋尿激酶组（US＋R＋UK）,进行在体溶栓治疗.将RGDS、微泡造影剂（SonoVue）和尿激酶通过直接联合法配制成6 ml的混悬液后经耳缘静脉注射,超声照射30 min,应用脉冲多普勒血流仪持续监测血流流速,对血流量和频谱变化特点进行分析.结果 120 min后US、UK、US＋M、US＋R及US＋M＋UK组血流量均未实现再通,R＋UK组血流量实现部分再通,US＋R＋UK组血流量完全再通（P＜0.001）.血流频谱特点为：未再通的各组在整个溶栓过程中血流频谱为持续小、低幅杂波;再通的R＋UK组和US＋R＋UK组溶栓时血流频谱出现持续高幅、杂乱的波,US＋R＋UK组溶栓时超声波与血流频谱产生共振变化.结论 在体溶栓时通与不通的血流频谱各具特点,超声共振效应是促进溶栓的可能机制.Objective To determine the effect of the combined use of urokinase and glycoprotein Ⅱb/Ⅲa-targeted microbubbles prepared by direct conjugation method to dissolve the thromb in vivo and analyse the velocity tracing change of blood flow and explore the possible mechanism. Methods A total of 42 rabbits with platelet-rich thrombi in the femoral artery were randomized into 7 treatment groups （ n = 6 in each group）： 1） ultrasound alone （US）; 2） ultrasound plus non-targeted microbubbles （ US ＋ M）; 3） urokinase alone （UK） ;4） ultrasound, non-targeted microbubble and urokinase （US ＋ M ＋ UK）; 5） ultrasound plus platelet-targeted microbubble （ US ＋ R）; 6） platelet-targeted microbubble plus urokinase （R ＋ UK）; 7）ultrasound, platelet-targeted microbubble and urokinase （US ＋ R ＋ UK）. A total of 6 ml of infusion liquor of Urokinase,RGDS and microbubbles （SonoVue） were mixed by 1 ∶ 1 ∶ 1 ratio by the direct conjugation method, infusion via vein within 20 min. Ultrasound was conducted to lyse the clot for 30 min. The recanalization and the velocity tracing change of blood flow in thrombolytic process were evaluated at 120 min post treatment. Results For US, UK, US ＋ M, US ＋ R and US ＋ M ＋ UK groups, recanalization was failed. The R ＋ UK and US ＋ R ＋ UK was recanalizated （ P ＜0.001 ）. The blood flow velocity tracing was small and low width in US,UK, US ＋ M, US ＋ R and US ＋ M ＋ UK groups. The wave was high width and disorderly under the thrombolysis therapy in the R ＋ UK and US ＋ R ＋ UK. The thrombolytic effect was demonstrated by the high-width and disorderly resonance changes in the blood flow spectrum during the thrombolytic therapy of US ＋ R ＋ UK. Conclusions The blood flow spectrum of groups had different characteristics in vivo when thrombus was issolved,ultrasonic resonance might be the possible mechanism.

关 键 词：超声检查 微气泡 血栓溶解疗法 尿纤溶酶原激活物 RGDS 

分 类 号：R686[医药卫生—骨科学]