尿激酶和去纤酶的溶栓作用及溶栓后对兔血管再闭塞的比较

Comparison of Urokinase and Defibrase on Their Effects of Thrombolysis and Reocclusion after Thrombolysis

采用兔股动脉血栓形成模型，比较了静脉输注尿激酶或去纤酶后，两药的溶栓作用及溶栓后血管再闭塞情况、作用机制。结果发现：尿激酶静滴≥１ｈ，造影见血管再通率为７３％，去纤酶静滴≤１ｈ，再通率为５３％。用药后６ｈ，尿激酶组血管再闭塞率５５％，去纤酶组仅２５％。两药均使纤维蛋白原（Ｆｇ·Ａｇ）含量、纤溶酶原激活物抑制物（ＰＡＩ）活性降低，优球蛋白溶解时间（ＥＬＴ）缩短，凝血酶原时间（ＰＴ）延长，但两者作用程度、时间不同。两药对血小板计数（ＢＰＣ）、血小板聚集率（ＰＡｇＲ）影响不明显，均未发现明显的出血副作用。结果表明：两组相比，尿激酶血管再通率高，去纤酶组血管再闭塞率低。两药均有激活纤溶系统及抗凝作用，但作用的侧重点不同。

This study was designed to compare urokinase(UK)with defibrase(DF)on their effects of fibrinolysis and occurence of reoccltision after thrombolysis. Experimental rabbits models for left femoral arterial thrombosis were made. The results showed:the recanalization rate of left femoral arteries assessed by angiography was 11 of 15 arteries(73%)within 1 h with intravenous infusion of UK and 8 of 15(53%)within 1 h with intravenous infusion of DF. Subsequently angiography characteristic at 6 h after infusion of agents disclosed total reocclusion from 6 of 11 recanalized arteries(55%)in UK group,and 2 of 8(25%)are partial reocclusion(arterial stenosis is≥75%)in DF group.In blood samples,fibrinogen(Fg·Ag)level was significantly lower,plasminogen activator inhibitor(PAI)activity was significantly decreased,euglobulinolysis time(ELT)was significantly shortened,prothrombin time(PT)was significantly prolonged in both UK and DF groups,But effective time-lapse and extent were not equal. No obvious effect on blood platelet count(BPC),platelet aggregation rate(PAgR)between 2 groups was observed,so there was no distinct manifestation of bleeding side-effect in all rabbits.These findings suggest that thrombolytic action of UK is stronger than that of DF,but effect of DF is stronger in preventing vessel reocclusion than that of UK. Both UK and DF possess the functions that activate fibrinolysis and resist coagulation,but each with a different emphasis.