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超声联合靶向微泡治疗急性脑血栓的动物实验研究

Animal Study in Combining Targeted-microbubbles with Low-frequency Ultrasound for the Treatment of Ischemic Stroke

  • 摘要: 【摘要】 目的 探讨超声联合靶向微泡治疗急性血栓的效果,以及对纤溶系统的影响。方法 采用脑血管造影后将大白兔自体血栓通过导管注入颈动脉制备脑血栓动物模型。6 h后造影确定血栓未自溶。49只大白兔分为4组。A组(n=13):经导管注射新型结合血小板Ⅱb /Ⅲa受体的靶向微泡(TMB);B组(n=12):经导管直接注射非靶向微泡(NTMB);C组(n=12):注射艾通立(重组纤溶酶原激活物r-TPA):D组(n=12):经导管注射生理盐水。A、B、D组均在治疗时应用低频超声(1 MHz,2.0 W/cm2)30 min。分别在治疗后立刻、1 h和2 h造影观察血栓溶解、血流再通情况,并在栓塞前和治疗后2 h取静脉血,检测凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fib)和D-二聚体。结果 A组6只(46.15%),B组1只(8.33%),C组4只(33.33%),D组1只(8.33%)血栓溶解,A、C组血栓溶解率高于B、D组(P0.05),组间差异也无统计学意义(P>0.05),而C组中D-二聚体高于其他组(P<0.05),Fib低于其他组(P<0.05)。结论 超声联合靶向微泡可快速溶解血栓使血管再通,其作用与 r-TPA相似而出血等副作用小。

     

    Abstract: 【Abstract】 Objective To study the treatment of ischemic stroke with combining targeted-microbubbles with low frequency ultrasound in animal model. Methods Cerebral thrombus animal model was established by the injection of autologous blood clots after cerebral angiogram through the carotid artery catheter in big white rabbit. With the confirm of thrombosis not being dissolved after angiography 6 h later, 49 big white rabbit were divided into four groups. Group A (n=13): direct injection of TMB through the vessel; group B (n=12): direct injection with nontargeted-microbubbles (NTMB) through the vessel; group C (n=12):direct injection with tissue plasminogen activator (r-TPA) through the auricular vein; group D (n=12): injection with saline through the vessel as control. Group A, B, D was given with transcutaneous temporal LFUS (1 MHz at 2.0 W/cm2) for 30 minutes. At 0 h, 1 h and 2 h after the treatments, imaging observation of thrombolytic and blood flow recanalization were performed. The venous blood was collected before and at 2 h after the treatment in embolization for the detection of prothrombin time (PT), thrombin time (TT),fibrinogen (Fib) and the d-dimer. Results Group A rabbit had six of 13 (46.15%) success thrombolysis, group B 12 rabbit had 1 of (8.33%) success thrombolysis,group C had 4 of 12 (33.33%) success thrombolysis,group D had 1 of 12 (8.33%) success thrombolysis. The thrombolytic rates of group A,C were higher than those of group B and D (P<0.01). After the treatments, the differences of PT, APTT,TT,Fib and the d-dimer in A,B and D group were not statistically significant, and d-dimer in group C was higher than that in other groups (P<0.05). Conclusion The treatment of combining targeted-microbubbles with low frequency ultrasound can rapidly release acute intracranial thrombotic occlusions, which has the same effect as r-TPA with less side effects.

     

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