不同溶栓药物治疗犬脑栓塞时血浆u-PA的变化

Effects of thrombolytic drugs on plasma level of u-PA in dogs with cerebral thromboembolism

目的观察不同药物溶栓治疗犬脑栓塞后血浆尿激酶型纤溶酶原激活剂(u-PA)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(CE)模型。选择健康成年杂种犬17只,随机分为3组。栓塞2h后,A组6只犬给予国产基因重组人尿激酶原(Pro-uk)静脉溶栓;B组6只犬给予尿激酶静脉溶栓;C组:5只犬给予生理盐水。观察血管开通情况,实验前、后血浆u-PA的变化。结果犬脑栓塞后2h给予不同处理,2h后造影证实:A组血管开通5只,B组血管开通2只,C组血管开通1只。A组0h和Pro-uk治疗后2h、3h血浆u-PA的值分别为(0.93±s0.26)μg·L-1、(26.0±2.8)μg·L-1、(8.2±2.3)μg·L-1;0h与2h、0h与3h、3h与2h比较,差异均有非常显著意义(P<0.01)。Pro-uk治疗后2h、3h血浆u-PA与B组和C组比,差异有非常显著意义(P<0.01)。结论血浆u-PA在一定程度上反映了犬CE后纤溶系统的变化,血管开通较高组血浆u-PA增高明显。犬CE后2h和Pro-uk溶栓后2h均出现了血浆u-PA水平增高。

AIM To observe the changes of plasma level of urokinase-type plasminogen activator （u-PA） after the use of Pro-uk and urokinase in dogs with cerebral thromboembolism （CE）, and to study the relationship between thrombolytic drugs and thrombolytic effects. METHODS The interventional radiology method was selected to establish the CE model in 17 dogs by the artery injection of auto artery blood thrombus, which was prepared by the fresh whole blood in vitro. Two hours after thrombus injection, the dogs were randomized into 3 groups and were treated with Pro-uk, urokinase （UK） and saline （NS）, respectively. Digital subtraction angiography （DSA） was used to observe the recanalization of occluded cerebral arteries, The levels of plasma u-PA were tested before CE （0 h）, 2 h and 3 h after treated with the drugs, respectively. RESULTS DSA showed that the dogs had the recanalization of occluded cerebral artery in Pro-uk, UK and NS group were five of six, two of six and one of five, respectively. The plasma level of u-PA was （0.93 ± s 0.26） ug.L^-1, （26.0 ± 2.8） ug·L^-1, （8.2 ± 2.3） ug·L^-1 at 0 h, 2 h and 3 h in Pro-uk group. The differences were statistical significant between 0h and 2h （P〈0.01）, 0h and 3h （P〈0.01）, 3h and 2h （P 〈 0.01）. The plasma levels of u-PA at 2 h and 3 h in Pro-uk group were higher than those in UK and NS groups （P 〈 0.01 ）. CONCLUSION The plasma level of u-PA reflects the changes of fibrinolysis system after CE in dogs in a certain sense and is high in the group that recanalization is high. The plasma levels of u-PA increase at 2 h after CE and 2 h after the use of Pro-uk.