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目的 探讨无溶栓药物条件下超声+微泡对血栓溶解的作用。方法 建立12只兔双侧股动脉急性血栓模型,对其中6只经静脉注射白蛋白微泡,一侧动脉接受经皮超声(超声+微泡组)而另一侧接受无超声治疗(微泡组)。另外6只兔一侧动脉只接受超声治疗(超声组)而另一侧不接受任何处理(对照组)。结果 单独超声治疗的6条动脉只有2条再通,接受超声+微泡治疗的6条动脉全部实现再通(P=0.014),微泡组和对照组动脉无再通。超声+微泡组动脉再通时间和残余血栓面积比值显著小于超声组(P=0.004,P=0.003 )。结论 超声作用下经静脉注射微泡能有效促进在体动脉血栓溶解,这对临床急性血栓形成患者有潜在的应用意义。 相似文献
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【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。 相似文献
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评价超声促进血栓溶解的有效性,并观察超声促进血栓溶解(超声助溶)的作用与超声强度、血栓形成时间的关系。用手术刀将免耳全层割穿,出血停止1h及4h后随机分组。对照组给予超声;单药组给予重组链激酶;药加超声用重组链激酶加超声。超声的频率为0.8MHz,强度分为1.2w/cm2、2.2w/cm2、。结果:1及4h切口,链激酶加超声组兔耳再出血时间明显短于单药组,P<0.001。链激酶加超声组4h切口的再出血时间均明显短于单药组1h切口的再出血时间。1.2w/cm2组与2.2w/cm2组1h切口的再出血时间无显著差别(P>0.05),但两组4h切口的再出血时间有显著差别(P<0.001)。单用超声,观察2h兔耳无再出血。结论:超声有促进药物溶解血栓的作用,从而缩短再通时间。单用超声,无溶栓作用。 相似文献
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目的 评价血管内超声消融治疗急性动脉血栓的有效性和安全性。方法 12条实验犬制作双侧股动脉急性血栓模型 ,血栓长度 >5cm。每条犬一侧股动脉血栓予超声消融治疗 2min ,另一侧仅用消融导管作机械性穿插。观察超声组和对照组操作前后血栓处的血流变化 ,比较两组血栓段动脉经实验操作后的损伤系数及远端栓塞情况。结果 股动脉血栓超声消融后远端血流量为 (2 8.9± 4 .2 )ml/min ,显著高于对照组的 (9.6± 5 .0 )ml/min(P <0 .0 1) ;超声消融后TIMI分级指数为 2 .6 7± 0 .4 9,而对照组为 1.0 8± 0 .90 (P <0 .0 1) ;血栓处动脉损伤系数分别为 1.83± 0 .39和 1.6 7± 0 .4 9(P >0 .0 5 )。超声消融后无远端动脉栓塞现象。结论 血管内超声消融术治疗急性动脉血栓有效、安全 相似文献
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目的对比兔颈动脉栓塞后接触性与非接触性溶栓对血管再通率、再通所需时间及溶栓药物剂量的影响.方法取新西兰白兔自体血,制成约1mm的血栓.直视下将血栓注入颈总动脉,血栓随血流栓塞于颈内动脉起始部.将20只兔分为接触组(n=8),非接触组(n=8)和对照组,行溶栓治疗.将尿激酶(4×104IU/kg)总量的20%在1分钟内经导管注入,余量在2小时内以微量注射器经导管匀速注入.每间隔20分钟,行DSA检查了解血管再通情况.记录血管再通时间和尿激酶用量.对照组(n=4)的设计为以生理盐水行接触性灌注,方法同前.结果①血管再通接触组6只、非接触组5只颈内动脉得以再通,对照组血管未能再通.②接触组血管再通时间为56.7±15分钟,非接触组为96±17分钟.两个治疗组尿激酶用量分别为2.31±0.40万IU/kg和3.46±0.45万IU/kg,接触组尿激酶用量较非接触组少.结论动脉内溶栓治疗对动脉栓塞后血管的再通是一种有效且安全的治疗方法.接触性溶栓较非接触性溶栓血管再通所需时间短,所需尿激酶的量少.在血管再通率上,两种方法无明显差异. 相似文献
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采用直流电刺激兔颈内动脉民局部血栓动物模型,分3组用药:生理盐水组、巴曲酶经静脉用药、巴曲酶经动脉用药组,以DSA监测血栓溶解情况。结果:巴曲酶动脉组再通率66.7%,明显高于巴曲酶静且(12.5%),生理盐水动脉组皆无再通。说明巴曲酶有溶栓作用,经劝脉用药效果显著优于经静脉用药的再通率。 相似文献
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目的:探讨微泡增强的超声空化增加睾丸组织的药物浓度的可行性。方法18只雄性8月龄性成熟新西兰兔随机分为空白对照组(C)、单纯微泡组(MB)、治疗超声组(TUS)、超声联合微泡辐照组(MEUS)4组,每组各9个。MB组给予静注微泡造影剂0.1 mL/kg ;TUS组给予超声辐照5 min;MEUS组给予静注微泡造影剂0.1 mL/kg的同时超声辐照5min;每组在治疗前5min均经耳缘静脉注射2%伊文思蓝(EB)2.5 mL/kg;治疗后1 h取各组睾丸组织制备组织匀浆测量 EB 浓度。结果 MEUS组兔睾丸组织内 EB 浓度高于其他各组(P<0.05),差异有统计学意义。结论微泡增强的超声空化可以明显提高睾丸组织内EB浓度。 相似文献
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目的研究血栓通注射液对脑缺血再灌注模型大鼠学习记忆行为的影响。方法将24只大鼠随机分为对照组、模型组与实验组3组,每组8只。模型组与实验组大鼠采用双侧颈总动脉阻断合并硝普钠降压法制作大鼠缺血性脑损伤模型;对照组大鼠未阻断颈总动脉、不注射硝普钠,其余处理同模型组、实验组。对照组、模型组大鼠于造模前1d至实验结束尾静脉注射生理盐水0.5mL/d,实验组注射血栓通注射液24mg/(kg·d)。通过Morris水迷宫定向航行、空间探索实验观察3组大鼠的逃避潜伏期及穿台次数。结果Morris水迷宫定向航行实验中,实验组各天逃避潜伏期与模型组相比,均有显著性差异(P〈0.05);与对照组相比,无显著性差异(P〉0.05)。空间探索实验中,实验组穿台次数与模型组相比有显著性差异[(4.6±2.1)次VS(3.4±2.4)次,P〈0.053;与对照组相比无显著性差异[(4.6±2.1)次VS(5.5±2.6)次,P〉0.05]。结论尾静脉注射血栓通注射液可以明显改善脑缺血再灌注损伤模型大鼠的学习记忆功能。 相似文献
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采用直流电刺激兔颈内动脉制成局部血栓动物模型,分3组用药:生理盐水组、巴曲酶经静脉用药组、巴曲酶经动脉用药组,以DSA监测血栓溶解情况。结果:巴曲酶动脉组再通率66.7%,明显高于巴曲酶静脉组(12.5%),生理盐水动脉组皆无再通。说明巴曲酶有溶栓作用,经动脉用药效果显著优于经静脉用药的再通率。 相似文献
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动脉闭塞性疾病血管内急诊介入治疗临床研究 总被引:1,自引:0,他引:1
目的评价探讨动脉闭塞(包括动脉栓塞和动脉狭窄伴血栓形成)疾病急诊介入治疗的临床意义。方法①导管内灌注尿激酶等溶栓药物或留置导管持续溶栓治疗;②机械导管碎栓负压抽吸伴药物溶栓治疗;③对局限狭窄采取经皮球囊扩张(PTA)和支架成形术。其中锁骨下动脉1例,骼动脉6例,股动脉5例,胭动脉2例,胫前、胫后及腓动脉和足部动脉2例。结果咒~(球囊扩张成形)或支架置入术后狭窄段的血管腔复通率100%,溶栓术后,血栓完全或大部分消失。患肢远端血运明显改善或恢复,临床症状好转或消失。DSA或B超随访,动脉均保持通畅。其中1例介入术后1周,因高血压病脑干出血死亡;3例脉管炎血栓坏疽者;2例截肢。结论采用急诊机械性和药物性溶栓术,结合PTA和支架治疗动脉闭塞性疾病,可有效地解除动脉闭塞,降低截肢率和致残率。 相似文献
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ExperimentalStudiesonPreventiveEffectsofAPI_(0134)on VesselReocclusionafterThrombolysisXIONGYi-li(熊一力);ZHAOHua-yue(赵华月)(Depar?.. 相似文献
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Summary 24 model rabbits with femoral arterial thrombosis were divided into two grocps: the treatment group consisting of 12 rabbits
which received API0134. and the control group composed of another 12 rabbits. 2 hours after recanalization by urokinase thrombolysis, reocilusion
occurred only in 1/12 vessel (8%) with incomplete occlusion in the treated group, but in 8/12 (67%) with complete occlusion
in the control group as assessed by angiograsphy. Pathological examination of specimen taken 24 hours after thrombolysis showed
that 6/12 (50%) of the treated group gave the evidence of thrombus occlusion, and milder intimai injury and less adhered blood
cells than in the control group, 83% of which had thrombus occlusion. In comparision with the control group, the function
of platelet in the treated group demonstrated lower platelet aggregation rate (PAgR) and plasma thromboxane A2 (TXA2) level, higher prostacyclin (PGI2) and plasminogen activator (PA) activity as well as lower plasminogen activator inhibitor (PAI) activity. From the above
it may be concluded that the preventive effect of API0134 on reocclusion might be due to inhibition of platelets aggregation and promotion of fibrinolysis. 相似文献
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目的探讨和评价应用介入手段治疗脑静脉窦血栓形成的疗效。方法选择宣武医院自2005年3月—2007年2月收治的28例脑静脉窦血栓形成的患者进行血管内治疗,其中18例行脑静脉窦机械性碎栓治疗和局部溶栓治疗,5例患者接受静脉窦置管溶栓合并颈内动脉溶栓,5例进行静脉窦置管溶栓合并静脉窦支架置入术。术后予以积极抗凝、抗血小板治疗,定期复查PT及PT值,将INR控制在2.0~2.5。结果出院前19例患者腰椎穿刺时颅内压在150~200mmH2O,血管造影或MRV检查证实静脉窦主干通畅,皮层静脉和深静脉恢复正常;8例患者部分再通,皮层静脉和深静脉部分代偿。27例患者的症状、体征都有不同的改善,其中22例头痛消失,3例有轻度头痛,2例视物不清,记忆力下降。1例因产后3周渐进性头痛、发热、意识障碍,经全脑DSA明确为颅内多发静脉窦血栓形成。虽积极予以静脉窦溶栓和碎栓治疗,但因患者病情严重,死亡。结论应用血管内治疗脑静脉窦血栓形成是一种安全、有效的治疗手段。 相似文献
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目的 :观察腔内超声融栓术治疗下肢动脉硬化闭塞性病变的临床疗效。方法 :应用腔内超声融栓术治疗下肢动脉硬化闭塞性病变患者 2 3例。术中采用穿刺或手术途径切开显露患侧股动脉 ,置入超声导管 ,将探头放置于血管阻塞部位 ,释放超声能量 ,使血栓或动脉硬化斑块得以碎解消融。结果 :2 2例患者术后造影显示动脉完全或部分再通 ,患肢变暖 ,术前疼痛症状消失或明显减轻 ,动脉搏动恢复 ,治疗总有效率 95 .7%。结论 :超声融栓是治疗下肢动脉硬化闭塞性病变的较好方法 ,具有快速、微创、安全及疗效可靠的优点。 相似文献
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超声溶栓治疗急性周围动脉血栓形成(附6例报告) 总被引:1,自引:0,他引:1
目的 评价血管内超声溶栓治疗急性周围动脉血栓形成的疗效。方法 6例患者经血管造影证实的股浅动脉血栓形成 3例、动脉血栓形成 2例、肱动脉血栓形成 1例 ,对下肢动脉血栓采用对侧或同侧股动脉穿刺 ,插入超声导管溶栓 ,对上肢动脉血栓采用股动脉穿刺 ,插入超声导管至上肢动脉溶栓。对 6例患者均进行 4~ 6min血管内超声溶栓治疗。结果 治疗后即刻造影显示血管内超声成功地溶解了 6例患者动脉内血栓 ,治疗 2 4h后有 1例患者发生了动脉再次血栓形成 ,其余 5例患者无再次血栓形成发生。结论 血管内超声溶栓可以有效地治疗周围动脉血栓形成。 相似文献
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Ultrasound-mediated microbubble delivery of pigment epithelium-derived factor gene into retina inhibits choroidal neovascularization 总被引:2,自引:0,他引:2
ZHOU Xi-yuan LIAO Qing PU Yi-min TANG Yong-qiang GONG Xiao LI Jia XU Yan WANG Zhi-gang 《中华医学杂志(英文版)》2009,122(22):2711-2717
Background Many studies have suggested that the imbalance of angiogenic factor and anti-angiogenic factor expression contributes significantly to the development of choroidal neovascularization (CNV), and ultrasound microbubble combination system can increase the gene transfection efficiency successfully. This study was designed to investigate whether ultrasound-mediated microbubble destruction could effectively deliver therapeutic plasmid into the retina of rat, and whether gene transfer of pigment epithelium-derived factor (PEDF) could inhibit CNV.
Methods Human retinal pigment epithelial cells were isolated and treated either with ultrasound or plasmid alone, or with a combination of plasmid, ultrasound and microbubbles to approach feasibility of microbubble-enhanced ultrasound enhance PEDFgene expression; For in vivo animal studies, CNV was induced by argon lasgon laser in rats. These rats were randomly assigned to five groups and were treated by infusing microbubbles attached with the naked plasmid DNA of PEDF into the vitreous of rats followed by immediate ultrasound exposure (intravitreal injection); infusing liposomes with the naked plasmid DNA of PEDF into the vitreous (lipofectamine + PEDF); infusing microbubbles attached with PEDF into the orbit of rats with ultrasound irradiation immediately (retrobular injection); infusing microbubbles attached with PEDF into the femoral vein of rats with exposed to ultrasound immediately (vein injection). The CNV rats without any treatment served as control. Rats were sacrificed and eyes were enucleated at 7, 14, and 28 days after treatment. Gene and protein expression of PEDF was detected by quantitative real-time RT-PCR, Western blotting and immunofluorescence staining, respectively. The effect of PEDF gene transfer on CNV was examined by fluorescein fundus angiography.
Results In vitro cell experiments showed that microbubbles with ultrasound irradiation could significantly enhance PEDF delivery as compared with microbubbles or ultrasound alone. In the rat CNV model, transfection efficiency mediated by ultrasound/microbubbles was significantly higher than that by lipofectamine-mediated gene transfer at 28 days after treatment. The study also showed that with the administration of ultrasound-mediated microbubbles destruction, the CNV of rats was inhibited effectively.
Conclusions Ultrasound-microbubble technique could increase PEDF gene transfer into rats' retina and chorioid, in association with a significant inhibition of the development of CNV, suggesting that this noninvasive gene transfer method may provide a useful tool for clinical gene therapy. 相似文献
Methods Human retinal pigment epithelial cells were isolated and treated either with ultrasound or plasmid alone, or with a combination of plasmid, ultrasound and microbubbles to approach feasibility of microbubble-enhanced ultrasound enhance PEDFgene expression; For in vivo animal studies, CNV was induced by argon lasgon laser in rats. These rats were randomly assigned to five groups and were treated by infusing microbubbles attached with the naked plasmid DNA of PEDF into the vitreous of rats followed by immediate ultrasound exposure (intravitreal injection); infusing liposomes with the naked plasmid DNA of PEDF into the vitreous (lipofectamine + PEDF); infusing microbubbles attached with PEDF into the orbit of rats with ultrasound irradiation immediately (retrobular injection); infusing microbubbles attached with PEDF into the femoral vein of rats with exposed to ultrasound immediately (vein injection). The CNV rats without any treatment served as control. Rats were sacrificed and eyes were enucleated at 7, 14, and 28 days after treatment. Gene and protein expression of PEDF was detected by quantitative real-time RT-PCR, Western blotting and immunofluorescence staining, respectively. The effect of PEDF gene transfer on CNV was examined by fluorescein fundus angiography.
Results In vitro cell experiments showed that microbubbles with ultrasound irradiation could significantly enhance PEDF delivery as compared with microbubbles or ultrasound alone. In the rat CNV model, transfection efficiency mediated by ultrasound/microbubbles was significantly higher than that by lipofectamine-mediated gene transfer at 28 days after treatment. The study also showed that with the administration of ultrasound-mediated microbubbles destruction, the CNV of rats was inhibited effectively.
Conclusions Ultrasound-microbubble technique could increase PEDF gene transfer into rats' retina and chorioid, in association with a significant inhibition of the development of CNV, suggesting that this noninvasive gene transfer method may provide a useful tool for clinical gene therapy. 相似文献