经导管注射微泡介导的体外超声溶栓实验  

Ultrasound thrombolysis mediated by transcatheter injection of microbubble in vitro

作　　者：郭梦娇[1] 高顺记[1] 屠娟[2] 刘政[1] 章东[2] 谢峰[3] 

机构地区：[1]第三军医大学新桥医院超声科,重庆400037 [2]近代声学教育部重点实验室,南京大学声学研究所,江苏南京210093 [3]内布拉斯加大学医学中心内科,内布拉斯加州奥马哈681980

出　　处：《中国介入影像与治疗学》2015年第3期169-173,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：国家自然科学重大仪器专项基金(81227004)

摘　　要：目的探讨经导管血栓内注射微泡对体外超声溶栓的增强作用。方法取新鲜人血血栓40份分为4组,每组10份,实验1组:血栓内注射尿激酶和微泡+超声,对照1组:血栓内注射尿激酶和微泡+超声假照;实验2组:经外周循环注射尿激酶和微泡+超声;对照2组:经外周循环注射尿激酶和微泡+超声假照,比较4组的溶栓率。超声频率1.0MHz,声压512kPa。另用超声激励MBDiO释放,观察治疗后血栓内荧光分布与强度。结果实验1组的溶栓率(37.70%±3.17%)显著高于实验2组(11.67%±1.13%)、对照1组(14.37%±2.22%)及对照2组(7.90%±0.68%,P<0.05)。血栓内注射微泡后,内可见大片强回声后伴声影,治疗后强回声区在血栓内有扩散。激光共聚焦显微镜观察实验1组治疗后血栓内可见大量明亮荧光信号分布,而实验2组治疗后的血栓内部基本无荧光信号。结论血栓内注射微泡和尿激酶介导的超声溶栓率显著高于经静脉给药方法。Objective To investigate the enhancement of ultrasound thrombolysis in vitro using transcatheter injection of microbubble.Methods Fresh human blood clots（n=40）divided into experimental group 1（n=10,transcatheter injection of microbubble and urokinase＋ultrasound）,experimental group 2（n=10,peripheral circulation injection of urokinase and microbubbles＋ultrasound）,control group 1（n=10,transcatheter injection of microbubble and urokinase）,control group2（n=10,peripheral circulation injection of urokinase and microbubbles）.Therapeutic US was operated at the frequency of1.0 MHz with the peak negative pressure of 512 kPa.The thrombolysis rate of clot was calculated after treatment.US release of MBDiO was observed fluorescent distribution and intensity in thrombus after treatment.Results The thrombolysis rate of experimental group 1（137.70%±3.17%）was significantly higher than that of experimental group 2（11.67%±1.13%）,control group 1（14.37%±2.22%）and control group 2（7.90%±0.68%,all P〈0.05）.Transcatheter injection of microbubble usually developed clusters of strong echo in thrombus with acoustic shadow.After treatment,the echo was scattered and spread.Laser confocal microscopy found that a large amount of bright fluorescent particles in the clots in experimental group 1,but rare fluorescence could be found in the clots in experimental group 2.Conclusion The thrombolysis rate of transcatheter injection of microbubble and urokinase＋ultrasound can significantly higher than the method of peripheral circulation injection of urokinase and microbubbles.

关 键 词：血栓形成 微泡导入法 溶栓 

分 类 号：R445.1[医药卫生—影像医学与核医学]