缺血性脑卒中超急性期动脉内灌注尿激酶速率的动物实验研究

目的：研究兔缺血性脑卒中超急性期动脉内灌注尿激酶进行溶栓治疗的最佳速率范围。材料与方法：３０只新西兰兔分成５组，均于颈内动脉内注入由全血加凝血酶制成的新鲜血栓混悬液０．２ｍｌ。在动物脑血栓模型建立１～２小时内进行颈内动脉尿激酶灌注溶栓，剂量为４万单位／公斤体重，浓度为８０００单位／亳升。５个实验组的注射速率为Ａ组：０．０１ｍｌ／ｓ；Ｂ组：０．０２ｍｌ／ｓ；Ｃ组：０．０４ｍｌ／ｓ；Ｄ组：０．１０ｍｌ／ｓ；Ｅ组：０．５０ｍｌ／ｓ。溶栓前后分别行血管造影，溶栓术后２４小时行病理检查。结果：５组溶通率分别为Ａ组：０．０％；Ｂ组：８３．３％；Ｃ组：１００．０％；Ｄ组：８３．３％；Ｅ组：０．０％。Ｂ、Ｃ、Ｄ组的溶通率与Ａ、Ｅ组相比有显著性差异（Ｐ＜０．０２５），Ｂ、Ｃ、Ｄ组之间的溶通率无显著性差异。结论：兔脑血栓形成超急性期动脉内灌注尿激酶进行溶栓治疗的有效速率范围为１６０～８００Ｕ／ｓ，以３２０Ｕ／ｓ左右的注射速率为最佳。

An experimental investigation on the rate of selective infusion of urokinase in superacute cerebral stroke in rabbit

Purpose: To study the optimal rate of intra arterial infusion of urokinase (UK)in superacute stage of cerebral stroke in rabbits.Materials and methods: Thirty rabbits were devided into A,B,C,D and E groups.All of the rabbits were given suspension of 0.2ml microclots formed by whole blood and thrombin.Intra arterial treatment with UK was initiated 1 2 hours after em bolization.The dose of UK was 40 000 U/kg,the concentration of UK was 8 000 U/ml.The rates of infusion were:A 0.01 ml/s;B 0.02 ml/s;C 0.04 ml/s;D 0.1 ml/s;E 0.5 ml/s.Angiography was performed before and after thrombolysis.Pathologic examination was performed 24 hours after thrombolysis. Results: The rate of recanalization of groups A,B,C,D and E were 0%, 83.3%, 100%, 83.3% and 0% respectively.Judged by angiography after thrombolysis,group B,C and D had significantly better reperfusion compared with group A and E ( P <0.025).Among groups B,C and D there were not significnat differences.Conclusion:The effective range of the rate of infusion of UK during superacute stage of cerebral stroke in rabbits is 160U/s to 800U/s, 320U/s being the best.