不同声学参数对血栓内微泡介导的超声辅助溶栓效果的影响  

Influence of acoustic parameters changes on sonothrombolysis effects mediated by transcatheter injection of microbubble

作　　者：高原[1] 郭梦娇[1] 高文宏[1] 高顺记[1] 刘政[1] 谢峰[2] 

机构地区：[1]第三军医大学新桥医院超声科,重庆400037 [2]内布拉斯加大学医学中心内科,奥马哈68198

出　　处：《中国医学影像技术》2015年第12期1783-1786,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金科学仪器专项(81227004)

摘　　要：目的探讨经导管向血栓内注射微泡和尿激酶后超声溶栓的体外实验中,不同声压和占空比对溶栓效果的影响。方法制备稀释的超声微泡并组装体外实验设备。将90份新鲜人血血栓样本平均分为9组,包括8个实验组（实验1-8组）及1个对照组。向血栓内注射0.02 ml微泡稀释液及2万U尿激酶,并对各组进行不同的超声辐照;实验1-4组固定占空比为10%,声压分别为285 kPa、512 kPa、708 kPa和931 kPa;实验5-8组固定声压为931 kPa,占空比分别为1%、2%、5%和10%;对照组不予超声辐照。计算并比较各组溶栓率的差异,并通过超声观察血栓表现及微泡分布情况。结果超声辐照后微泡在血栓内有均匀扩散并逐渐减少的趋势。固定占空比时,实验3、4组溶栓率明显高于对照组（P〈0.01）,实验4组溶栓率高于实验1组（P〈0.05）;固定声压时,实验6、7、8组溶栓率均明显高于对照组（P均〈0.01）,实验8组溶栓率明显高于实验5组（P〈0.01）。其余各组间溶栓率差异均无统计学意义（P均〉0.05）。结论向血栓内注射微泡和尿激酶有助于增强超声溶栓效果,超声辐照时以声压708 kPa、占空比〉2%为宜。Objective To investigate the influences of different acoustic pressure and duty cycle on in vitro ultrasound thrombolysis using transcatheter injections of microbubble and urokinase.Methods An in vitro ultrasound thrombolysis system was designed.And the microbubble solution was prepared.A total of 90 fresh human blood clots were randomly divided into 9 groups,including 8 study groups and a control group.The injections of 0.02 ml microbubble solution and20000 IU urokinase were performed on all clots.The ultrasonic irradiations were also done in different groups.The duty cycles were 10%stably,while the acoustic pressure was 285 kPa,512 kPa,708 kPa and 931 kPa in study groups 1—4,respectively.The acoustic pressures were 931 kPa stably,while the duty cycle was 1%,2%,5%,and 10%in study groups5—8,respectively.The control group was treated as sham ultrasound exposure.The thrombolysis rate of different groups were calculated and compared.High resolution ultrasound was used to observe ultrasonic findings of clots and distribution of microbubble.Results The microbubble were diffused uniformly and trend to decrease in the clots.For the different acoustic pressure effect study,the thrombolysis rate of study groups 3 and 4 was separately higher than that of control group（both P〈0.01）,while the thrombolysis rate of study group 4 was higher than that of study group 1（P〈0.05）.For the different duty cycle effect study,the thrombolysis rate of study groups 6,7 and 8 was separately higher than that of control group（all P〈0.05）,while the thrombolysis rate of study group 8 was higher than that of study group 5（P〈0.01）.No statistical difference of the thrombolysis rate was found among another groups（all P〉0.05）.Conclusion Transcatheter injections of microbubble and urokinase have an enhanced effect of ultrasound thrombolysis.The parameters of acoustic pressure as 708 kPa and duty cycle more than 2%are favorable.

关 键 词：声学参数 微泡 血栓栓塞 溶栓治疗 

分 类 号：TB559[理学—物理]