从诱发兔耳血管损伤后再出血评价体外超声助溶血栓的效果

Accelerating Thrombolysis by Therapeutic Ultrasound from Induced Rebleeding of Rabbit Ear after Injury

目的评价体外治疗性超声（简称超声）促进血栓溶解的有效性。方法用手术刀将２２只兔耳全层割穿，共１７６处。出血停止１小时及４小时后随机分组。单用超声组、单用重组链激酶（ｒ－ＳＫ）组和ｒ－ＳＫ加超声组，后者又根据超声强度不同分成１．２Ｗ／ｃｍ２和２．２Ｗ／ｃｍ２两个亚组。超声的频率均为０．８ＭＨｚ。结果单用超声组，观察２小时兔耳无再出血。１及４小时切口，ｒ－ＳＫ加超声组兔耳再出血时间明显短于单用ｒ－ＳＫ组（Ｐ＜０．００１）。１．２Ｗ／ｃｍ２组与２．２Ｗ／ｃｍ２组１小时切口的再出血时间无显著差别（Ｐ＞０．０５），但４小时切口的再出血时间后者显著短于前者。结论超声有促进ｒ－ＳＫ溶解血栓的作用。

Objective The purpose was to assess the efficacy of therapeutic ultrasound to enhance thrombolysis by inducing rebleeding of rabbit after injury in vivo. Methods One hundred and seventy six full thickness puncture wounds in rabbit ears were made in 22 rabbits. The rabbits were randomly allocated to different groups according to 1 and 4 hours after cessation of bleeding: ① Ultrasound adding saline group; with ultrasound at 2.2 W/cm2, ② recombinant streptokinase (rSK ) alone group, and ③ combining rSK and ultrasound group. Ultrasound was applied at 0.8 MHz with a 50% duty cycle at 1.2 W/cm2 and 2.2 W/cm2 intensities. Results: There was no rebleeding phenomena after 2 hours in ultrasound adding saline group. The rebleeding times were shorter in ultrasound plus rSK group than in rSK alone group (P<0.001). The rebleeding times of 4 hour lesions in ultrasound plus rSK group were shorter than that of 1 hour lesions in rSK alone group. The rebleeding times with 1.2 W/cm2 were not significantly different compared to that with 2.2 W/cm2 for 1 hour lesions (P<0.05). But for 4 hour lesions the latter was shorter than the former (P<0.001). Conclusion Therapeutic ultrasound can accelerate thrombolysis with rSK.