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降纤酶治疗脑梗死的实验研究
引用本文:黄如训,曾进胜,陈立云,刘冰,李玲,苏镇培,卢林.降纤酶治疗脑梗死的实验研究[J].中国神经精神疾病杂志,2001,27(5):335-337.
作者姓名:黄如训  曾进胜  陈立云  刘冰  李玲  苏镇培  卢林
作者单位:中山医科大学附属第一医院神经科,
基金项目:卫生部科学研究基金资助(编号:98-2-390)
摘    要:目的观察降纤酶对光化学模型诱导的大鼠大脑中动脉血栓的溶栓作用及对脑梗死灶的影响.方法应用光化学方法造成60只易卒中型肾血管性高血压大鼠(RHRSP)大脑中动脉(MCA)血栓形成,在3h、6h、9h、12h、1d不同的时间点对大鼠静脉注射3种产地的降纤酶8U/kg,对照组注射等容生理盐水,观察2d,对大鼠进行行为学评分、MCA血流测定、梗死灶体积测定、病理改变及出血情况观察.结果降纤酶组3小时以内的血栓全部溶解,6小时内的部分溶解.降纤酶组各时间点无论血栓溶解与否,大鼠的行为学评分、梗死灶体积均较生理盐水组低,梗死灶周围微血管闭塞较生理盐水组少.但在降纤酶组中有2例发生出血,分别发生于血栓后6h、12h用药组.结论降纤酶对6小时以内的血栓有溶栓作用,对3小时以内的血栓溶解率最高.降纤酶除溶栓作用外,还可减少梗死灶体积,抑制微血管的血栓形成,改善微循环,改善卒中的预后.与其他溶栓剂相比并不增加出血并发症的发生.

关 键 词:降纤酶  易卒中型肾血管性高血压大鼠  脑梗死  光化学模型
修稿时间:2001年7月14日

Experimental study on effects of defibrase in treatment of middle cerebral artery thrombosis and cerebral infarction.
Abstract:Objective To study the effects of defibrase on treating middle cerebral artery (MCA) thrombosis and cerebral infarction induced by photochemical reaction in stroke-prone renovascular hypertensive rats (RHRSP). Methods The MCA thrombus in RHRSP was induced by a photochemical reaction between green light and the photosensitizing dye Rose Bengal, which causes endothelial injury followed by formation of a platelet and fibrin-rich thrombus at the site of photochemical reaction. Defirase was injected intravenously at 3, 6, 9, 12 hours and 1 day after MCA thrombosis, whereas the control group received only normal saline. Neurological functions were scored on 5 points scale 48 hours after treatment. The thrombus in MCA was determined by transcranial Doppler (TCD) and by HE staining. Infractin size was measured by triphenyltle trazolium chloride (TTC) staining, and cerebral hemorrhage was examined macroscopically. Results In the treatment group, the thrombi were dissolved totally at 3 hours and partially dissolved at 6 hours in the treatment group. The thrombus was not be dissolved by defibrase after 9 hours of MCA thrombosis. Defibrase improved neurological functions and reduced infarction size. There were 2 rats occurred cerebral hem- orrhage at 6 and 12 hours in the treatment group. However, compared with urokinase and tissue-type plasminogen activator, defi- brase did not increase the incidence of cerebral hemorrhage. Conclusions Defibrase can reduce infarction size and improve neu- rological functions and has an effect of thrombosis within 6 hours after MCA thrombosis without increasing in the incidence of cere- bral hemorrhage.
Keywords:Defibrase    Stroke-prone renovascular hypertension rats Cerebral infarction            Photochemical reaction thrombosis
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