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BACKGROUND: As a non-invasive technique which can provide comprehensive biological information, 1H-magnetic resonance spectroscopy (1H-MRS) may provide valuable reference data for irreversible recovery or reversible changes in ischemic tissue after stroke.
OBJECTIVE: To monitor and evaluate the effect of the urokinase thrombolytic therapy after experimental acute cerebral ischemia by 1H-MRS technology and investigate its adaptability.
DESIGN: Randomly controlled animal study.
SETTINGS: Shenzhen Hospital of Peking University and National Key Laboratory of Pattern and Atom & Molecular Physics, Wuhan Physics and Mathematics Institute, Chinese Academy of Science.
MATERIALS: Eleven healthy adult Sprague-Dawley (SD) rats, weighing 260–300 g and of both genders, were supplied by Experimental Animal Center of Tongji Medical Collage, Huazhong University of Science and Technology [SCXK (e) 2004-007]. 4.7T superconducting nuclear magnetic resonance meter was provided by Brucker Company.
METHODS: The experiment was carried out in Shenzhen Hospital of Peking University and National Key Laboratory of Pattern and Atom & Molecular Physics, Wuhan Physics and Mathematics Institute, Chinese Academy of Science from August 2003 to December 2005. ① The rats were randomly divided into 30-minute self-thrombo-embolism group (n =6) and 60-minute self-thrombo-embolism group (n =5). Six rats in 30-minute self-thrombo-embolism group were occluded with clot embolus for 30 minutes and 5 rats in 60-minute self-thrombo-embolism group were occluded for 60 minutes. 10 000 U/kg urokinase was dissolved in 2 mL saline and the operation lasted for 5 minutes. ② 1H-MRS was performed before thrombolysis and at 3 hours and 24 hours after successful embolization. The metabolic changes of N-acetyl-L-aspartic acid (NAA)/phosphocreatine (PCr) + creatine (Cr), choline phosphate (Cho)/PCr+Cr and lactic acid (Lac)/PCr+Cr in the region of interests were analyzed. ③ The T2W image was conducted 24 hours after the thrombolytic therapy with TR=500 ms and TE=25 ms. ④ The subjects were sacrificed immediately after 1H-MRS and the brain tissues were cut into pieces and stained with HE method; in addition, pathological changes were observed under optic microscope.
MAIN OUTCOME MEASURES: ① Metabolic changes of NAA/PCr+Cr, Cho/PCr+Cr and Lac/PCr+Cr in the region of interests; ② T2W image at 24 hours after the thrombolysis; ③ pathological observation of brain tissue.
RESULTS: Eleven rats were all involved in the final analysis. ① Metabolic changes in the region of interests : In 30-minute self-thrombo-embolism group, the Lac peak emerged immediately after the embolism, but the ischemic zone decreased 3 hours after the thrombolytic therapy (0.252±0.01, 0.603±0.01, P < 0.01). Lac/(PCr+Cr) ratio was 0.290±0.01 at 24 hours after thrombolysis, which was higher than that at 3 hours after thrombolysis (P < 0.01). The NAA/ (PCr+Cr) ratio decreased significantly at 3 hours after the thrombolysis as compared with that before thrombolysis (0.922±0.16, 1.196±0.01, P < 0.05). In 60-minute self-thrombo-embolism group, the Lac/(PCr+Cr) ratio was higher at 3 hours after thrombolysis than that before thrombolysis (0.846±0.12, 0.601±0.11, P < 0.05) and the NAA/(PCr+Cr) decreased at 3 hours after the embolism. Fluctuation of NAA/ (PCr+Cr) ranged from 0.68 to 0.75 before thrombolysis and from 0.71 to 0.75 at 3 hours after thrombolysis. ② T2W image: T2W image showed that 2 subjects in 30-minute self-thrombo-embolism group whose Lac/NAA was higher than 0.7 suffered from intracranial hemorrhage. This meant that the subjects with Lac/NAA > 0.7 were more likely to suffer from intracranial hemorrhage. ③ Histological and morphological examinations: Optic microscope demonstrated that interspace surrounding nerve cells was widened at ischemic center; neurons were swelling; nucleus was stained lightly; pyknosis and mesenchymal edema were mainly observed in lateral cortex of brow and vertex and in lateral part of corpus striatum.
CONCLUSION: ①Compound parameters in ischemic area before thrombolysis should be regarded as an important predicting marker for thrombolytic therapy, effect evaluation and termination. ② 1H-MRS combining with other imaging technique is a detecting way for screening cases who are suitable for thrombolytic therapy. 相似文献
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本文介绍使用氨气敏电极,采用标准曲线法简便、快速、准确测定血氨的方法。取空腹血1ml,用1M HClO_4沉淀蛋白,以0.1M NH_4Cl—0.6MNa_2SO_4作内充液,碱化后的上清液可在2~3min内测试完毕。40例正常成人血氨的测定结果:■=31.4μmol/L N;S=6.4μmol/L N;■±2S(正常值范围)为18.6~44.2μmol/L N。10份血样的平均回收率为100.4%。该法用血少、简便、快速;结果较稳定、准确,适用于临床检验。 相似文献
47.
通过具体的实验数据,讨论在药代动力学实验中如何加入曲线下面积(AUC)的计算,以帮助学生理解并掌握这一概念;在实验室设置不同剂量组,给药后比较剂量与浓度是否呈等比例关系,以此加深学生对于一级动力学消除及其临床意义的理解。 相似文献
48.
CT导引经皮穿刺注射无水乙醇治疗溶骨性骨转移瘤 总被引:1,自引:1,他引:0
目的探讨CT导引下经皮穿刺注射无水乙醇(CT~PEI)治疗溶骨性骨转移瘤的价值及安全性。方法对17例骨转移瘤患者(25个病灶)采用CT—PEI治疗,使用无水乙醇和超化碘油10:1的混合剂,用CT精确定位、准确穿刺瘤灶并密切监控无水乙醇弥散情况及用量,以减少并发症。对接近椎管及椎间孔的病灶,采用利多卡因实验性治疗以避免严重并发症。术前及术后定期CT检查,3例病人行同位素骨扫描检查,与治疗前检查进行对照研究。对患者随访3~30个月观察其临床疗效。结果所有患者经1次CT—PEI治疗后,疼痛即明显减轻,经2~3次CT-PEI治疗后疼痛完全缓解(CR)16例(24处病灶),疼痛部分缓解(PR)1例。术后随访3个月时,23处病灶内肿瘤组织均发生坏死,被高密度碘油混合液均匀浸润。其中,9处病灶体积缩小。随访3~30个月,除1例因周边出现新的肿瘤浸润灶而再次出现疼痛,其余病例转移瘤处止痛效果无反复。所有病例无严重并发症。结论CT—PEI是一种治疗骨转移瘤有效、微创、安全、简便的方法,使骨转移瘤内肿瘤组织坏死,最大限度的杀灭肿瘤细胞,从而达到满意的止痛效果,明显改善恶性肿瘤溶骨性转移病人的生活质量。 相似文献
49.
目的 :研究多发性骨髓瘤 ( MM)患者血浆尿激酶型纤溶酶原激活物 ( u- PA )及其可溶性受体 ( su PAR )的水平变化 ,并探讨其临床意义。方法 :用 ELISA法检测 34例 MM患者血浆 u- PA及 su PA R的浓度 ,同时观察其中6例 MM患者化疗前后血浆 u- PA及 su PAR的浓度变化。结果 :MM患者血浆 u- PA及 su PA R水平均明显高于正常对照组 ,其中进展期 MM患者血浆 u- PA及 su PAR水平明显高于正常对照组和稳定期 MM患者 ( P <0 .0 1) ,而稳定期 MM患者血浆 u- PA及 su PA R水平与正常对照组无显著性差异 ( P>0 .0 5)。 6例 MM患者化疗后血浆 u- PA及 su PA R水平 ,明显低于化疗前血浆 u- PA及 su PAR水平 ( P<0 .0 5)。骨髓涂片瘤细胞比例 >2 0 %的 MM患者血浆 u- PA及 su PA R水平 ,明显高于瘤细胞比例≤ 2 0 % M M患者 ( P<0 .0 5;P<0 .0 1)。M M患者血浆 u- PA及su PA R水平均与骨髓瘤细胞百分比及血清球蛋白呈正相关 ,而与血清白蛋白呈负相关。结论 :血浆 u- PA及 su PA R水平升高可能与多发性骨髓瘤的发生、发展有密切关系 ;其水平可作为临床分期、判断疗效、了解疾病进展情况及预后的一个重要指标。 相似文献
50.
马绍云 《中华临床医学研究杂志》2007,13(12):1714-1714
我院自2005年4月至2007年3月对60例胆汁反流性胃炎的患者,采用泮托拉唑钠肠溶维生素K3治疗,取得显著疗效,现报告如下。 相似文献