血管内超声导管联合微泡增强尿激酶溶栓的实验研究  

Enhanced urokinase thrombolysis by endovascular ultrasound catheter and microbubbles:a experimental study

作　　者：董睿 朱琼 冯爽 朱贤胜 高顺记 刘政 DONG Rui;ZHU Qiong;FENG Shuang;ZHU Xiansheng;GAO Shunji;LIU Zheng(Department of Ultrasound,the Second Affiliated Hospital of Army Medical University,PLA,Chongqing 400037,China)

机构地区：[1]中国人民解放军陆军军医大学第二附属医院超声科,重庆市400037 [2]中国人民解放军南部战区总医院超声影像科 [3]中国人民解放军中部战区总医院超声科

出　　处：《临床超声医学杂志》2020年第2期85-89,共5页Journal of Clinical Ultrasound in Medicine

基　　金：广州市科技计划项目(201707010083);湖北省卫计委科研基金面上项目(WJ2018H0078);武汉市中青年医学骨干人才基金

摘　　要：目的探讨EKOS■超声导管联合血栓内注射微泡增强尿激酶体外溶栓治疗效果。方法采用水听器法测量EKOS■超声导管峰值负压。将90份体外牛血血栓样本根据其实验方法随机分为6组,分别为:超声+微泡+尿激酶联合组(联合组)、超声+尿激酶组(US+UK组)、超声+微泡组(US+MB组)、超声组(US组)、尿激酶组(UK组)和对照组,每组15份,称取各组溶栓前后的血栓质量,计算并比较其溶栓率。对溶栓处理后各组血栓行HE染色并于光镜下观察红细胞和纤维蛋白的分布情况。结果EKOS■超声导管的峰值负压在0.4~6.4 MPa,呈无规律动态变化。联合组溶栓率为(41.9±4.5)%,与US+UK组(42.0±3.3)%接近,均显著高于其余各组,差异均有统计学意义(均P<0.05);US+MB组溶栓率为(28.4±3.3)%,UK组为(27.8±3.1)%,两组比较差异无统计学意义,但均高于US组(23.9±3.0)%和对照组(17.5±3.7)%,差异均有统计学意义(均P<0.05)。光镜下见联合组和US+UK组与EKOS■超声导管接触处的血栓较多崩解,红细胞分布较其余各组更稀疏。结论EKOS■超声导管可明显提高尿激酶对体外牛血血栓的溶栓率,在此基础上增加微泡对溶栓率无明显提高。Objective To investigate the thrombolytic effect of EKOS■ultrasound catheter combined withintrathrombotic microbubbles(MB)on urokinase(UK)thrombolysis.MethodsThe peak negative pressure(PNP)of the EKOS■catheter was measured by hydrophone method.Ninety bovine thrombus samples in vitro were randomly divided into six groups:ultrasound(US)+MB+UK(combined group),US+UK group,US+MB group,US group,UK group and control group,each grouphas 15 samples.The thrombus quality of each group was weighed before and after thrombolysis,and thrombolysis rate wascalculated and compared.After treatment,the thrombus in each group wasstained with HE,and the distribution of erythrocyte andfibrin was observed under a light microscope.ResultsThe PNP of EKOS■catheter varied irregularly within the range of 0.4~6.4 MPa.The thrombolysis rate of combined group(41.9±4.5)%was close to that of US+UK group(42.0±3.3)%,which weresignificantly higher than that of the other groups(all P<0.05).The thrombolysis rate of US+MB group was(28.4±3.3)%,comparedwith(27.8±3.1)%in UK group,there was no significant difference between the two groups,which were significantly higher thanthat of US group(23.9±3.0)%and control group(17.5±3.7)%,there were significant difference(both P<0.05).Histologicalexamination of the thrombus in combined group and US+UK group showed that the thrombus contacting with EKOS■catheter wasmore disintegrated,and the distribution of red blood cells was more sparse than other groups.Conclusion EKOS■catheter canobviously improve the thrombolysis rate of UK to bovine thrombus in vitro,however,MB has no significant effect on thrombolysis rate.

关 键 词：EKOS■超声导管 微泡 尿激酶 溶栓 

分 类 号：R445.1[医药卫生—影像医学与核医学]