肝素对大鼠thy-1肾炎肾小球细胞增生和u-PA／PAI?1表达的影响

目的研究u-PA及其抑制物PAI-1在大鼠thy-1肾炎中的表达及意义,并探讨肝素治疗对其表达的影响。方法应用ABC免疫酶标法及图像分析技术,观察对照组、肾炎组和肝素组动物模型肾小球u-PA和PAI-1的表达情况,并与光镜下肾小球细胞计数作相关性分析。结果肝素组动物在其治疗后7、14、21d时,肾小球细胞数明显减少,与肾炎组比较P值分别小于0.05或0.01肾炎组、肝素组肾小球u-PA和PAI-1的表达均高于对照组;于实验3、7、14和21d时,肾炎组动物的肾小球细胞数增多与u-PA和PAI-1的表达呈正相关(P<0.05或0.01);肝素组于实验3、7d时,肾小球细胞数的减少与PAI-1表达降低有关(P<0.05)。结论大鼠thy-1肾炎的肾小球细胞数增多与其u-PA和PAI-1表达程度呈正相关;肝素治疗可减轻大鼠thy-1肾炎肾小球细胞增生,其作用机制可能与病程早期对肾小球PAI-1表达的抑制有关     

Proteolysis and invasiveness of brain tumors: Role of urokinase-type plasminogen activator receptor

Summary The cellular receptor for urokinase-type plasminogen activator (uPAR) in glioblastoma cell lines has been identified and found to be similar to the uPAR expressed by other tumor cell lines. Increased levels of uPAR have been found in primary malignant brain tumor tissues, especially highly malignant glioblastoma, and, to a lesser degree, in malignant astrocytomas, suggesting that this receptor might be involved in efficient activation of pro-uPA and confinement of uPA activity on the cell surface of invading brain tumors. The cell surface uPARs in gliomas could constitute an optimum environment for the generation and activity of plasmin, which is known to play a crucial role in the dissolution of the extracellular matrix during tumor cell invasion.In situ hybridization studies have shown that uPAR mRNA is expressed abundantly in tumor cells and is consistently present at the invasive edges of malignant gliomas. These results imply that uPAR is involved in plasmincatalyzed proteolysis during glioma invasion and that interference with the uPAuPAR interactions could constitute a novel approach for developing therapeutic strategies to counteract invasion of brain tumors.     

uPA系统在4株非小细胞性肺癌细胞中的表达

目的：研究尿激酶型纤溶酶原（ｕ Ｐ Ａ） 激活系统中４ 种主要成分ｕ Ｐ Ａ、 Ｐ Ａ Ｉ１ 、 Ｐ Ａ Ｉ２ 、ｕ Ｐ Ａ Ｒ 在非小细胞性肺癌细胞株中的表达及各因子之间的作用方式。方法：应用免疫组化、蛋白免疫印迹技术对培养细胞中４ 种成分进行定位、定性及半定量分析;应用斑点杂交技术检测４ 种细胞中ｕ Ｐ Ａ ｍ Ｒ Ｎ Ａ 和ｕ Ｐ Ａ Ｒｍ Ｒ Ｎ Ａ 的表达。结果：４ 种成分在４ 株细胞的胞浆及胞膜均有表达。蛋白免疫印迹法检测ｕ Ｐ Ａ、 Ｐ Ａ Ｉ１ 、 Ｐ Ａ Ｉ２ 、ｕ Ｐ Ａ Ｒ,４ 株细胞均在约１４０ ｋｕ 和约８０ ｋｕ 处出现特异性条带,且两种腺癌细胞的表达水平显著高于其他两株细胞。斑点杂交结果示４ 株细胞中均有ｕ Ｐ Ａ ｍ Ｒ Ｎ Ａ 和ｕ Ｐ Ａ Ｒ ｍ Ｒ Ｎ Ａ 的表达。结论：此４ 株细胞中均能合成与分泌ｕ Ｐ Ａ 系统的４ 种主要成分,各因子以二联及三联复合物（ｕ Ｐ Ａ／ Ｐ Ａ Ｉ１ 、ｕ Ｐ Ａ／ Ｐ Ａ Ｉ２ 、ｕ Ｐ Ａ／ｕ Ｐ Ａ Ｒ、ｕ Ｐ Ａ／ Ｐ Ａ Ｉ１／ｕ Ｐ Ａ Ｒ、ｕ Ｐ Ａ／ Ｐ Ａ Ｉ２／ｕ Ｐ Ａ Ｒ） 的形式存在;ｕ Ｐ Ａ 系统的表达与这４ 种细胞的恶性程度并不一致。     

静脉溶栓治疗对AMI患者左室重构的影响

目的 观察静脉溶栓治疗对ＡＭＩ患者左室重构的影响。方法 选择确诊为ＡＭＩ并经静脉溶栓治疗患者８２例,按临床非侵入性冠脉再通四项指标判定,８２例中再通４８例（再通组）未通３４例（未通组）。于梗塞后４～６周,平均５．４周行心脏彩色多普勒超声检理,测量左室舒张末期内径（ＬＶ）,左室射血分数（ＥＦ）,左室短轴缩短率（ＦＳ）,舒和早期峰值轿流速度／舒张晚期峰值血流速度（Ｅ／Ａ）,血流经过二尖瓣口的降速率（Ｄ     

动脉内溶栓治疗急性脑梗死

为了前瞻性研究局部动脉内溶栓治疗急性脑梗死的疗效,应用超导技术对３７例急性脑梗死病临近梗死部位的脑血管内注入溶栓药物治疗。其中２２例使用蝮蛇抗栓酶３号,１５例使用尿激酶溶栓,结果：２７．０３％的患者在６小时内溶栓,２４．３２％在７～１２小时内,２１．６３％在１３－２４小时内,２４．３２％在２５～４８小时内,２．７％在４８小时以后溶栓,溶栓后症状明显好转者占５９．５％,好转者２１．６％,无改善１８．     

Renal vein thrombosis and selective arterial or venous thrombolytic therapy

Summary Background: Renal vein thrombosis (RVT) complicating the nephrotic syndrome is associated with a poor prognosis. Methods/Results: RVT was diagnosed in 12 of 60 patients with a diagnosis of nephrotic syndrome suggested by computed tomography (CT) and subsequently confirmed by selective renal angiography. Fifty patients carried a diagnosis of primary glomerulonephritis with various pathological findings, and 10 patients had lupus nephritis. Renal vein and peripheral vein blood samples were collected in the 12 patients with RVT and were assayed for fibrin(ogen) degradation products (FDP), antithrombin III (AT III), VIIIR:AG, and fibrinogen. The results suggested a state of hypercoagulation. Of these 12 patients, 7 were given 200,000 units of urokinase (UK) over 60 minutes in divided doses selectively via the renal vein. Five patients were given 200,000 units UK selectively into the renal artery. All patients also received 2.5 mg/day warfarin and 75 mg/day persantine. Except for three patients with focal glomerulosclerosis, all patients received 40 mg/day prednisone. After 1 month, the CT scan and blood samples for FDP, AT III, VIIIR:AG, and fibrinogen were repeated. Patients receiving intra-arterial UK had complete resolution of their thrombi. Complete resolution was also suggested in 2 of the 7 patients receiving UK by renal vein, and there was partial resolution in the other five. The hypercoagulation state decreased in all patients. Conclusions: We conclude that RVT is not an uncommon event in patients with nephrotic syndrome. The diagnosis can be supported reliably using abdominal CT scanning. Although a small number of patients were included in this nonrandomized study, it appeared that intra-arterial thrombolytic therapy yielded better results. The patients with minimal change disease have a good prognosis.     

小剂量尿激酶联合低分子肝素治疗不稳定心绞痛的疗效观察

目的针对不稳定型心绞痛(UA)的发病机理,比较小剂量尿激酶(UK)联合低分子肝素(LMWH)与常规方法联合LMWH治疗UA的疗效,以探讨治疗UA的合理方案。方法采用随机分组,对照小剂量UK联合LMWH组及常规治疗联合LMWH组的疗效。结果采用小剂量UK联合LM-WH组比常规治疗联合LMWH组能更快控制症状(P<0.05),无明显副作用,近期疗效确切,但两组的有效率差异无显著意义(P>0.05),故仍是一种价-效比适合的方案。结论在目前介入疗法普及率有限的情况下,在基层医院尤其适用,并为有条件的患者赢得时间。     

静脉溶栓治疗高龄急性心肌梗死患者的临床探讨

目的　探讨静脉溶栓疗法对高龄急性心肌梗死患者的疗效及安全性。 方法　将 82例高龄急性心肌梗死患者随机分为溶栓组和常规治疗组。溶栓组 40例 ,采用尿激酶静脉溶栓加皮下注射低分子肝素钙。常规治疗组 42例 ,除不用尿激酶及低分子肝素钙外 ,其余治疗均与溶栓组相同。 结果　 血管再通率溶栓组为6 5 %(2 6 / 40 ) ,常规治疗组为 14.3%(6 / 42 ) ,两组血管再通率比较差异具有显著性 (P <0 .0 5 )。溶栓组未见严重出血等并发症。住院 4周内病死率为 5 %。而常规治疗组病死率为 2 3.8%(10 / 42 ) ,两组比较具有显著差异性(P <0 .0 5 )。 结论　 尿激酶静脉溶栓治疗高龄急性心肌梗死可以提高冠脉再通率 ,降低死亡率和改善预后 ,是可行性治疗措施。     

尿激酶肝素治疗急性脑梗死临床研究

目的研究小剂量尿激酶与肝素治疗急性脑梗死的疗效及安全性.方法将100例急性脑梗死患者随机分为治疗组和对照组(各50例),治疗组给以小剂量尿激酶10万U加生理盐水50ml颈动脉注射,另 给以肝素50～100mg加生理盐水250ml静脉滴注,每日一次,共七天.对照组给以复方丹参20ml加生理盐水250ml,静脉滴注,每日一次,连用15d,两组均合并用甘露醇、阿斯匹林等.结果治疗后一周及治疗后一个月进行神经功能缺损状态评分,治疗组分别为8.2±2.9,9.6±4.6,对照组分别为4.4±2.3,7.3±2.4,两组对比有显著差异(P＜0.05),无出血并发症.结论小剂量尿激酶与肝素治疗急性脑梗死疗效肯定,安全性较好.     

溶栓及经皮冠状动脉介入术治疗急性心肌梗死的疗效分析

目的：对比直接冠状动脉介入术(PCI)及静脉尿激酶(UK)溶栓治疗急性心肌梗死(AMI)的疗效。方法：采用观察性队列研究的方法，对97例AMI患者采用UK溶栓(UK组)，60例AMI患者采用直接PCI治疗(PCI组)，比较两组住院期及随访期的超声心动图(UCG)和临床结果。结果：住院期UCG检查室壁运动正常率及LVEF在PCI组高于UK组，矛盾运动发生率则PCI组低于UK组。住院期心衰及随访期累计心衰的发生率UK组高于PCI组。住院期病死率两组间差别无统计学意义；随访期累计病死率UK组明显高于PCI组。60岁以上年龄组累计的病死率仍然是UK组高于PCI组。在随访3、6、12及24个月时PCI组的生活质量计分均高于同时期UK组的计分。结论：直接PCI治疗AMI患者与UK治疗相比能改善左室重构、减少心衰的发生率、降低病死率、提高患者的生活质量。对于有条件的病人和医院应提倡用直接PCI治疗AMI。