肺动脉栓塞不同时相的尿激酶溶栓疗效观察的实验研究

目的探讨肺动脉栓塞不同时相的尿激酶溶栓的疗效。方法成功制作11头小型猪肺动脉栓塞实验模型(另1头死于出血性肺梗死),以尿激酶作为溶栓剂,观察在栓塞不同时相(栓塞术后30min、栓塞术后10天、术后30天)的溶栓治疗效果。结果实验小型猪在肺动脉栓塞急性期(3头次)以尿激酶15×104U溶栓治疗后被栓塞肺动脉恢复通畅;亚急性期(3头次)以30×104U尿激酶后得到同样结果;慢性期(3头次)以50×104U尿激酶溶栓后,肺动脉三级分支内的血栓完全溶解,再追加5×104U尿激酶,肺动脉四级分支内血栓明显减少。结论肺动脉栓塞不同时相的尿激酶溶栓治疗均有一定的疗效,急性期和亚急性期较慢性期的疗效好,不同时相的溶栓治疗所需尿激酶剂量随栓塞时间延长而呈递增趋势。

Thrombolytic effects at different time-window with urokinase in pig model of pulmonary embolism

Objective To investigate the thrombolytic effect with urokinase at different time-window in the pig model of pulmonary embolism. Methods Eleven of 12 pig models of pulmonary embolism were successfully established and 1 died of pulmonary hemorrhagic infarction. The effect of experimental thrombolytic therapy with urokinase at different time-window (30 min, 10 days and 30 days after embolism operation) was observed by angiography. Results In 9 of 11 pulmonary embolism pig models treated with experimental thrombolytic therapy, successful recanalization was observed by angiography when urokinase been given 15×10⁴ U for 3 pigs in acute period (30 min after embolism operation), 30×10⁴ U for 3 pigs in sub-acute period (10 days after embolism operation), and 50×10⁴ U for 3 pigs in chronic period (30 days after embolism operation). Conclusion Thrombolytic therapy for pulmonary embolism with urokinase at different time-window was effective. The thrombolytic effect for the pig models in acute and sub-acute period was better than pigs in chronic period. Thrombolytic dose of urokinase was increasing with the time after embolism operation.