诊断超声介导微泡造影剂助溶兔静脉血栓的体内实验研究

Efficacy of ultrasound and microbubbles on augmentation phlebothrombosis inrabbit：an in vivo study

目的研究诊断超声结合自制白蛋白微泡造影剂在体内的溶栓效应，并探讨其与尿激酶联用在溶栓方面的协同作用及溶栓机制。方法32只健康家兔建立股静脉血栓模型，分为单纯尿激酶组、超声＋微泡造影剂组、超声＋微泡造影剂＋尿激酶组和阳性对照组。根据前期的体外实验所确定的最佳参数组合，并联合尿激酶进行溶栓，利用彩色多普勒超声技术对各组不同时间点15min、30min、60min的血管再通情况进行检测，评价血管的再通率。取溶栓治疗后的兔股静脉标本进行免疫组化检测，比较各组管腔内部结构及溶栓效果，并对其溶栓机制进行探讨。结果治疗15min与30min后，超声＋微泡造影剂＋尿激酶组的血管再通率较单纯尿激酶组、超声＋微泡造影剂组均显著增加，差异有统计学意义（P〈0．05）；治疗60min后，超声＋微泡造影剂＋尿激酶组血管再通评分要明显优于其他两组。免疫组化检测结果示超声＋微泡造影剂＋尿激酶组治疗60min后股静脉内血栓结构崩解，纤维素断裂，血管腔大部分融通，优于治疗15min、30min时的溶栓效果。结论诊断超声结合自制微泡造影剂在体内具有明显的溶栓效应，与尿激酶联用在溶栓方面有很好的协同作用。

Objective To study the effects of diagnostic ultrasound combined with microbubble contrast agent on augmentation thrombolysis in vivo and to discuss the synergism and mechanism of combination of urokinase. Methods Thirty-two rabbits of femoral vein thrombus were divided into four groups： simple urokinase group, ultrasound and contrast microbubble group, ultrasound and contrast microbubble combined with urokinase group, control group. Then according to the best parameter combination which was definited in previous experiment, the experiments combination of urokinase were performed. Color Doppler was used to evaluate the recanalization of different group in 15 min,30 rain and 60 min. Results After the treatment of 15 min and 30 min,the recanalization rate in ultrasound and contrast microbubble combined with urokinase group improved significantly compared with other groups （ P〈 0.05） ;after 60 min,the recanalization grade of ultrasound and contrast microbubble and urokinase group was evidently better than other two group. The result of immunohistochemistry showed that disaggregation of clot and fibrous in this group at 60 min was better than the results at 15 min,30 rain. Conelusions Diagnostic ultrasound with microbubble contrast agent showed superior effects of thrombolysis and the synergism of combination of urokinase in vivo.