治疗用超声辅助尿激酶溶栓作用的体外研究

目的 在体外环境下,评估治疗用超声溶栓作用以及影响尿激酶溶栓效率的因素.方法 从血液离体后分别在3、4、5、6、7、8、9、10 h 8个时间点制备离体血栓并开始溶栓,分为生理盐水组(NS),尿激酶组(UK),生理盐水+超声组(NS+US),尿激酶+超声组(UK+US),每组32份血栓,放入37 ℃的水浴环境下干预1 h后再称重,计算血栓失重和溶栓率并观察离体血栓存放时间对尿激酶溶栓效果的影响.结果 UK组和UK+US组的溶栓率分别是29.3%±8.2%、37.5%±7.9%,两者比较LSD-t值为12.1,P＜0.01,差异有统计学意义,NS组和NS+US组的溶栓率分别是13.4%±4.4%、14.5%±5.4%,两者相比较LSD-t值为1.8,P值为0.08,差异无统计学意义;在一定范围内,离体血栓存放时间越长,溶栓率越低.结论 在体外环境下,治疗用超声可能本身并无溶栓作用,但可以明显增强尿激酶的溶栓作用;在一定范围内,离体血栓存放时间越长则溶栓率越低.

An in vitro study on ultrasound-enhanced urokinase-mediated thrombolysis

Objective To evaluate whether therapeutic ultrasound, applied alone or with urokinase, may have a thrombolytic effect on blood clots in vitro, and the other factors influencing the urokinase-mediated thrombolysis. Methods Experiments were carried out in an in vitro blood clot model.The blood clots were divided into four groups as physiological solution group(NS), urokinase group(UK),physiological solution plus ultrasound group(NS + US), urokinase group plus ultrasound group(UK + US).After intervention of one hour in static 37 ℃ water bath, each group of blood clots was weighed. After that,the weight loss and thrombolysis rate of the blood clots in each group were calculated. To observe the impact of the age of the blood clots on urokinase-mediated thrombolysis rate, the thrombolysis rate of eight time points 3, 4, 5, 6, 7, 8, 9, 10 hours was tested. The time was determined from the blood drawn from the body to the initiation of thrombolysis test. Results In terms of thrombolysis rate, there was significant difference between UK group and UK + US group(LSD-t 12. 1, P ＜ 0.01), with a thrombolysis rate 29. 3% ±8. 2% and 37. 5% ±7. 9%, respectively. However, the difference of thrombolysis rate between NS group and NS + US group with a thrombolysis rate 13. 4% ±4. 4% and 14. 5% ± 5.4%, respectively,was not statistically significant with a P value of 0. 08(LSD-t 1.8). The age of the blood clots had a negative correlation to the thrombolysis rate to some extent. Conclusion Therapeutic ultrasound has a significant effect on thrombolysis in combination with urokinase rather than used alone. To a certain extent,the thrombolysis rate decreases with the age of blood clot.