超声导入尿激酶治疗颈动脉粥样硬化斑块的实验研究

目的探索经皮超声波导入尿激酶消融兔颈动脉及其分支动脉粥样硬化斑块的疗效。方法兔动脉粥样硬化模型组分为自然消退组喂饲普通颗粒饲料;超声波组进行颈内动脉处超声波频率干预;超声波导入尿激酶组同单纯超声波组技术参数,在超声探头上的海面薄膜上加入5万IU/ml/个尿激酶;静脉给予尿激酶组由耳缘静脉推注尿激酶,10万IU/d。分别连续推注10d和20d。于干预后第10天和第20天处死动物,取材进行颈动脉彩色多普勒超声检查、血脂测定及颈动脉病理切片观察。结果超声波治疗10d组与20d组的血脂水平差异无统计学意义。超声波导入尿激酶20d组与10d组TG、LDL和HDL比较差异具有统计学意义,静脉给予尿激酶组差异亦具统计学意义（P〈0.01）。超声波10d组、超声波导入尿激酶20d组斑块体积较其他各组明显减少（P〈0.001）。超声波20d组管壁中膜最厚,斑块体积最大,与其他各组相比有统计学意义（P〈0.001）,但最大斑块虽占血管腔面积百分比并不是最大。最大斑块所占管腔面积百分比以静脉给予尿激酶10d、20d组最为严重,自然消退10d组和超声波10d组次之,超声波导入尿激酶组较轻。结论连续经皮超声导入尿激酶可缩小颈动脉软斑,降低斑块数目,减轻管腔狭窄程度,加快血流速度,改善脑缺血症状其疗效优于单纯超声治疗和静脉给予尿激酶的疗效。

Experimental Study on Therapeutic Effect of Rabbits Carotid Atherosclerotic Plaques with Urokinase by Ultrasonic Phonophoresis

Objective To explore the efficacy of rabbits percutaneous ultrasound urokinase import for carotid artery ablation and its branches atherosclerotic plaques.Methods The atherosclerotic disease model rabbits that feed in high-fat food for 3 months were randomly divided into atherosclerosis natural team（ASNT）,ultrasound team（UT）,ultrasound urokinase importing team（UUT）and intravenous urokinase team（VIUT）.Use of urokinase was 100,000 IU/each/d,carotid artery color Doppler ultrasound examination has been taken after continuous treatment for 10 d and 20 d,and the blood lipids and carotid artery measured slices of cases observed has been taken also.And the results were analyzed statistically.Results Ultrasound urokinase importing team（UUT）and intravenous urokinase team（VIUT）in lipids indexes decreases especially TG,LDL and HDL,after continuous treatment for10 d 20 d.The results show that compared with others groups,ultrasound team and ultrasound urokinase importing team has the least number of plaques and the significant difference was（P0.001）,and the largest plaque volume reduces obviously（P0.001）.Pure ultrasound treatment group in membrane thick wall（P0.001）,VIUT group wall thickness less than the UUT group（P0.001）.Except the ultrasound guided drug group and the ultrasound treatment group,spontaneous regression group（ANS）and the intravenous treatment group（VIUT）could be seen further branching occurred in the small arteries of lipid plaques more serious.The largest share of the lumen area in intravenous urokinase team is the most serious,and the ultrasound team and ultrasound urokinase importing team is not serious（P0.001）.Conclusion Consecutive percutaneous ultrasound can significantly reduce the 20-day clinical carotid artery soft plaque,reduce the number of plaques,reduce lumen stenosis and accelerate blood flow velocity.Its efficacy is superior to simple super-acoustic treatment and the efficacy of intravenous administration of urokinase.External therapeutic ultrasound has the advantage of non-invasive,easy to operate,strong targeting and it is worthing clinical practice and application.