溶栓治疗时间窗与ICAM-1表达关系的实验研究

The relationship between ICAM-1 expression and thrombolytic therapeutic time window in the rats embolic stroke model

目的探讨溶栓治疗时间窗与细胞间粘附分子1(ICAM1)表达的关系。方法采用血栓栓塞模型,缺血0.5h、1h和4h开始溶栓治疗,缺血12h和24h采用TTC染色测定梗死灶大小,免疫组织化学方法观察ICAM1表达;并观察颅内出血的发生例数。结果缺血12h和24h,4h溶栓组较0.5h和1h溶栓组,梗死灶体积明显增大(P<0.01),缺血周边区ICAM1面密度明显增加(P<0.01);1h溶栓治疗组较0.5h溶栓组梗死灶体积增大(P<0.05),ICAM1面密度增加(P<0.05)。缺血24h与缺血12h比较,0.5h溶栓组ICAM1面密度减少(P<0.05);而1h和4h溶栓组明显增加(P<0.05,P<0.01)。4h溶栓组有4只发生颅内出血,其余各组无颅内出血发生。结论缺血时间越长,溶栓治疗后缺血周边区ICAM1越明显,发生颅内出血例数增加;超早期溶栓治疗可以减小梗死灶,减少缺血周边区ICAM1表达。

Objective To evaluate the relationship between ICAM-1 expression and thrombolytic therapeutic time window in the rats embolic stroke model. Methods The MCA was embolized by autogenous thrombi and 0.5h, 1h or 4h. After ischemia, urokinase was administered through the catheter in ECA. Infarct size was calculated by TTC staining. ICAM-1 expression was evaluated by immunohistochemistry, either 12h or 24h after ischemia. Results After 12h or 24h ischemia, infarct volume and dense of ICAM-1 were significantly reduced in 0.5h and 1h thrombolysis groups compared with those in 4h thrombolysis groups(P<0.01). These parameters were reduced in 0.5h thrombolysis group compared with this in 1h thrombolysis groups. The dense of ICAM-1 were lesser in 0.5h group, but greater in 1h and 4h thrombolysis groups after 24h ischemia than that of 12h ischemia(P<0.05). Conclusion Ultra-earlier thrombolysis could reduce ICAM-1 expression in margin of ischemia and reduce the inflammatory reaction.