溶栓干预犬脑栓塞后血浆u-PA和u-PAR水平变化的实验研究

The levels of u-PA and u-PAR during thrombolysis therapy of canines cerebral embolism:An experimental study

目的观察尿激酶原(pro-UK)和尿激酶(UK)干预犬脑栓塞后血浆尿激酶型纤溶酶原激活剂(u-PA)和尿激酶型纤溶酶原激活剂受体(u-PAR)的变化,及其与溶栓效果的关系。方法自体动脉血凝固制备栓子,使用介入方法建立犬脑栓塞模型。栓塞2h后,分别用pro-UK和UK溶栓,分为A、B 2组,造影观察血管开通情况;实验前(0 h)、治疗后2h和3h时u-PA和u-PAR的变化。结果犬脑栓塞后2 h给予不同溶栓药处理,2 h后造影证实:A组6只中血管开通5只,B组6只中血管开通2只;A组溶栓后2h、3h血浆u-PA值比溶栓前(0h)升高(P<0.01),且2 h比3 h时u-PA值高(P<0.01);B组溶栓后2h、3h与0h时比较u-PA值无明显变化(P>0.05)。2组间2h、3h时u-PA值比较差异有统计学意义(P<0.01)。2组间和2组内不同时间点血浆u-PAR水平差异无统计学意义(P>0.05)。结论血浆u-PA在一定程度上反映了犬脑栓塞溶栓后纤溶系统的变化,血管开通比例较高,血浆u-PA增高明显。血浆u-PAR在pro-UK、UK溶栓后变化不大,与犬血管开通无明确关系。

Objective To investigate the changes of plasma levels of urokinase-type plasminogen activator（u- PA） and urokinase-type plasminogen activator receptor（u-PAR） with the chugs intervention of pro-UK and urokinase （UK） in cerebral embolism, and to evaluate the relationship between them and thrombolytic effects, Methods A ca- nine thromboembolism model was established through intervention, which injected auto artery blood thrombus into the canines＇ artery. After 2 hours, the pro-UK and UK was applied in group A and B respectively. All animals were underwent digital subtraction angiography （DSA） examination and evaluated the recanalization of occluded cerebral arteries. The levels of plasma u-PA and u-PAR were detected before thrombeembolism,2 h and 3 h after being treated respectively. Results The DSA resalts showed that 5 of 6 canines had recanalization of occluded cerebral artery 2 hours after intravenous pro-UK in group A; 2 of 6 canines had recanalization of occluded cerebral artery 2 hours after intravenous UK in group B. In group A, the level of u-PA increased gradually after treatment（ P 〈 0.01 ）, and it showed statistical signifinanee difference between 2 h and 3 h （ P 〈 0.01 ）. Otherwise, it didn＇ t showed statistical signifinanee difference in group B after 2 h and 3 h （ P 〉 0.05）. The difference was statistical significance, intravenous pro-UK vs. intravenous UK （ P 〈 0.01 ）. The level of u-PAR in different time point didn＇t showed significant difference compared inter-group and intro-group （ P 〉 0.05）. Conclusion The level of plasma u-PA coald represent the changes of fibrinolysis system after thrombolysis in canines thrombeembolism. The plasma u-PA level was high in animal which recanalization. There was no exact relationship between the plasma u-PAR levels and recanalization of occluded cerebral arteries in canines.