经颅多普勒超声联合局部亚低温对颅内血栓溶解的影响

Effect of Transcranial Doppler Ultrasound Combined with Focal Mild Hypothermia on Encephalic Thrombolysis

目的评价经颅多普勒超声(TCD)联合局部亚低温辅助尿激酶溶栓治疗脑梗死的有效性。方法使用32只兔制备大脑中动脉栓塞模型,将动物随机分为TCD组、尿激酶组、TCD+尿激酶组、TCD+尿激酶+亚低温组(局部亚低温组),每组8只,记录不同时间点的大脑中动脉血流速度,判断血管再通情况,观察病变处脑温是否达到亚低温水平。结果局部亚低温组血管再通率为87·5%,TCD+尿激酶组血管再通率为75%,均高于尿激酶组(P<0·05);局部亚低温组壳核温度在30min内已降至亚低温水平。结论局部亚低温脑保护仪在与TCD联用的情况下,可使脑温在允许的时间窗内降至亚低温水平;TCD联合局部亚低温可增强尿激酶的溶栓效果。

Objective To determine the effect of transcranial Doppler ultrasound （TCD） combined with focal mild hypothermia on cerebral infarction treated with thrombolytic unokinase （UK）. Methods 32 rabbits were randomly divided into the TCD group, UK group, TCD＋UK group and hypothermia group with 8 animals in each group. Mean velocities of the middle cerebral artery were recorded after unokinase infusion to estimate whether blood vessels reopened. Meantime, brain temperature of lesion site was tested to find out whether declined to hypothermia level. Results The percentage of recanalization was 87.5% in the hypothermia group, 75 in the TCD＋UK group, significantly higher than that in the UK group （37.5%）（P〈0.05）. After 30 minutes of the rabbit refrigerated at 2 ℃, the putamen temperature declined to 32℃～34℃. Conclusion Apply the regional refrigerstor apparatus to decline the brain temperature to mild hypothermia level during therapeutic time window. TCD combined with focal mild hypothermia can improve the thrombolytic effect of unokinase.