超声联合微泡对不同凝龄富血小板血栓和富红细胞血栓的溶栓效果

目的 探讨超声联合微泡对不同凝龄富血小板血栓（PRT）和富红细胞血栓（ERT）的溶栓效果。方法 分别于体外和大鼠体内颈总动脉制备不同凝龄的PRT和ERT。离体及在体实验均分为4组,即离体PRT 3 h组、离体PRT 24 h组、离体ERT 3 h组、离体ERT 24 h组及在体PRT 3 h组、在体PRT 24 h组、在体ERT 3 h组、在体ERT 24 h组；分别于体外循环装置和大鼠颈总动脉血栓模型中进行超声联合微泡溶栓实验,并采集超声图像。行病理组织学检查以验证血栓成分。离体实验主要分析溶栓后管腔横截面积增加百分比及溶栓率,在体实验主要分析溶栓后血管再通率及颈总动脉血流速度。结果 溶栓治疗后,离体及在体实验显示：PRT 3 h组与ERT 3 h组管腔横截面积增加百分比（121.12±13.21）% vs （130.09±15.34）%]、溶栓率（39.83±7.09）% vs （42.14±5.17）%]、血管再通率（83.33% vs 91.67%）及颈总动脉血流速度（0.21±0.02）m/s vs （0.22±0.01）m/s]差异均无统计学意义（P均>0.05）。PRT 24 h组与ERT 24 h组比较、PRT 24 h组与PRT 3 h组比较、ERT 24 h组与ERT 3 h组比较,管腔横截面积增加百分比、溶栓率、血管再通率、颈总动脉血流速度均下降（P均<0.05）。与ERT 24 h组比较,PRT 24 h组管腔横截面积增加百分比、溶栓率、血管再通率及颈总动脉血流速度均下降（P均<0.05）。结论 超声联合微泡对溶解离体及在体大鼠颈总动脉PRT和ERT的效果随血栓凝龄的增加而下降,且以PRT为著。

Efficacy of microbubble-enhanced sonothrombolysis on platelet-rich thrombi and erythrocyte-rich thrombi of different ages

Objective To investigate the efficacy of microbubble-enhanced sonothrombolysis on platelet-rich thrombi (PRT) and erythrocyte-rich thrombi (ERT) in different ages. Methods PRT and ERT in different ages were prepared both in vitro and in vivo of common carotid artery in rats. All the participants were divided into 8 groups with 4 in vitro and another 4 in vivo experiment, including PRT 3 h, PRT 24 h, ERT 3 h, ERT 24h in vitro groups and PRT 3 h, PRT 24 h, ERT 3 h, ERT 24 h in vivo groups. Microbubble-enhanced sonothrombolysis was carried out in both in vitro and in vivo experiments, and the ultrasonic images were collected. The components of PRT and ERT were identified by histopathological examination. The percentage increase of luminal cross sectional area and lytic ratio in vitro, and the recanalization rate and mean blood flow velocity of common carotid artery in vivo were mainly analyzed. Results After sonothrombolysis, both in vitro and in vivo experiment showed there was no statistically significant difference of the percentage increase of luminal cross sectional area (121.12±13.21]% vs130.09±15.34]%), lytic ratio (39.83±7.09]% vs42.14±5.17]%), recanalization rate (83.33% vs 91.67%) and blood flow velocity of common carotid artery (0.21±0.02]m/s vs0.22±0.01]m/s) between PRT 3 h group and ERT 3 h group (both P>0.05). PRT 24 h group compared with EPR 24 h group, PRT 24 h group compared with PRT 3 h group, as well as ERT 24 h group compared with ERT 3 h group, the percent increase of luminal cross sectional area, lytic ratio, recanalization rate and blood flow velocity of common carotid artery reduced (all P<0.05). Conclusion The efficacy of microbubble-enhanced sonothrombolysis on PRT and ERT in vitro and in vivo of of rat common carotid artery model decrease with the increase of thrombus age, especially for the PRT.