兔大脑中动脉栓塞模型的建立及初步应用*

目的：建立兔大脑中动脉（ＭＣＡ）栓塞模型，并应用重组葡萄球菌激酶（ｒ－Ｓａｋ）进行动脉内溶栓治疗。方法：新西兰兔１５只，在脑血管数字减影造影（ＤＳＡ）监测下，用自体血凝块注入颈内动脉，形成ＭＣＡ栓塞模型，经颈内动脉分别灌注生理盐水１０ｍｌ，ｒ－Ｓａｋ０．４ｍｇ／ｋｇ及尿激酶（ＵＫ）４×１０４ＩＵ／ｋｇ，以ＤＳＡ造影及脑梗死范围、行为障碍评分评价溶栓治疗的效果；测定凝血指标及纤维蛋白原（Ｆｇ），观察药物对全身凝血与纤溶系统的影响。结果：ｒ－Ｓａｋ组栓塞血管溶通率１００％（５／５），ＵＫ组溶通率４０％（２／５）。两组脑梗死范围均显著缩小，行为障碍改善。ＵＫ组Ｆｇ明显下降，凝血酶时间、部分凝血活酶时间及凝血酶原时间延长，而ｒ－Ｓａｋ组则无变化。结论：在所建立的兔ＭＣＡ栓塞模型上通过早期动脉内溶栓可改善动物行为障碍，缩小脑梗死范围；ｒ－Ｓａｋ较ＵＫ具有更强的溶血栓作用，并具有纤维蛋白特异性，不会引起系统纤溶亢进。

Intra-arterial thrombolysis with recombinant staphylokinase in a rabbit middle cerebral artery embolic stroke model

Objective: To establish a rabbit middle cerebral artery (MCA) embolic stroke model, and to study intra-arterial thrombolysis with recombinant staphylokinase (r-Sak) in this model. Methods: Fifteen rabbits were subjected to a model of RMCA embolic stroke by injected autologous clots into the right internal carotid arterial. Thirty minutes after embolization, the rabbits were treated with saline, r-Sak 0.4 mg/kg or urokinase (UK) 4×104 IU/kg intra-arterial. Digital subtraction angiograms were performed every thirty minutes. Results: RMCA were reopened 100%after injection of r-Sak vs 40%reopened after injection of UK (P<0.01). The ischemia and neurological impairment in both groups were limited. UK prolonged thromb in time, kaolin prothrombin time and prothrombin time, decreased fibrinogen whereas r-Sak did not influence these factors. Conclusion: In the rabbit model of MCA embolic stroke, r-Sak is fibrin-specific and is more effective in lysing embolic clots than UK.