不同时长超声照射(TCCS)结合MBS、rt-PA联合溶栓的效果评估  

Evaluation of the Effect of Different TCCS Durations Combined with MBS and rt-PA on Thrombolysis

作　　者：张海春[1] 陈莉[2] 胡蓉菲[1] 任新平[3] 朱婷[1] 

机构地区：[1]复旦大学附属华山医院宝山分院超声科 [2]复旦大学附属华山医院静安分院超声科 [3]上海交通大学医学院附属瑞金医院超声科

出　　处：《中国医学计算机成像杂志》2016年第5期398-402,共5页Chinese Computed Medical Imaging

摘　　要：目的:探讨不同时长超声照射(TCCS)联合微泡(MBS)和重组组织型纤溶酶原激活剂(rt-PA)对体内溶栓的效果。方法:建立大鼠自体血栓动脉栓塞模型:将血栓经颈外逆行置入颈总动脉内,临时阻断结扎,形成动脉血栓模型。超声照射时间设定为两个时间点:15min时间点及30min时间点。动物随机分为5组:1对照组;2 rt-PA组;3 TCCS+MBS组;4 rt-PA+TCCS+MBS组;5 1/2 rtPA+TCCS+MBS组。通过二维超声和彩色多普勒超声评估各组颈动脉血管再通率。结果:TCCS治疗加入MBS及rt-PA对于血管溶栓的再通率有显著提高。在溶栓15min时间点:仅rt-PA+TCCS+MBS组与对照组溶栓再通率比较,差异有统计学意义;在溶栓30min时间点观察:对照组与rt-PA组、rtPA+TCCS+MBS、1/2rt-PA+MBS+TCCS组之间溶栓再通率比较,差异均有统计学意义(P<0.05);rt-PA+TCCS+MBS与rt-PA组和单纯TCCS+MBS组比较,均有统计学意义(P<0.05)。结论:在治疗缺血性脑卒中方面,TCCS+MBS联合rt-PA是一种有效的方法,具有协同作用,时长30min明显优于15min溶栓效果。Purpose： To evaluate the effect of different TCCS durations combined with MBS and rt-PA on thrombolysis. Methods： A rat thrombosis model was built up by putting a thrombus into the common carotid artery. The rats were randomly divided into 5 groups： （1） Control group; （2） rt-PA group; （3） TCCS ＋ MBS group; （4） rt- PA ＋ TCCS ＋ MBS group; （5） 1/2 rt-PA ＋ TCCS ＋ MBS group. Each group was performed 30 minutes TCCS; and the data was recorded at the 15th minute and the 30th minute. The carotid artery revascularization rate of each group was evaluated by ultrasonography and TCCS. Results： The revascularization rate was increased obviously by TCCS ＋ MB and rt-PA. At the 15th minute of TCCS, the difference of the revascularization rates of rt-PA ＋ TCCS ＋ MBS group and control group was with statistical significant. At the 30th minute of TCCS, the differences of the revascularization rates of control group and rt-PA group, rt-PA＋TCCS＋MBS group, 1/2 rt-PA＋MBS＋TCCS group were with statistical significant （P〈0.05）. Conclusion： TCCS＋MBS combined with rt-PA is an effective solution in treating ischemic stroke. The thrombolysis effect of 30 minutes TCCS is obviously better than that of 15 minutes TCCS.

关 键 词：超声辅助溶栓 对比剂 

分 类 号：R743.3[医药卫生—神经病学与精神病学]