重组葡激酶和尿激酶在治疗实验性视网膜中央动脉阻塞中的比较

Comparison of recombinant staphylokinase and urokinase in the treatment of experimental occlusion of the central retinal artery

目的 观察重组葡激酶 (recombinant staphylokinase,r- Sak)治疗实验性视网膜中央动脉阻塞(central retinal artery occlusion,CRAO)的效果及其对全身的影响。 方法 15只猫 (30只眼 )静脉注射光化学药物 3%孟加拉红后 ,用氩绿激光照射视网膜动脉形成阻塞模型 ,静脉给予 r- Sak和尿激酶 (urokinase,U K)溶栓 ,通过荧光素眼底血管造影判断动脉再通情况 ,同时作血液生化指标的检查。 结果 成功地建立了 CRAO模型 ,实验用药给药 4h后 ,r- Sak组 CRAO的完全再通率为 10 0 % ,而 UK组的完全再通率仅为6 0 %。使用 r- Sak后血液中凝血、纤溶、抗纤溶指标与空白对照组比较均差异无显著意义。 结论 光化学法可建立和临床相似的 CRAO模型 ,R- Sak是一种高效安全、特异性强的溶栓药 ,在临床治疗 CRAO上有较好的应用前景。

Objective To inspect the effects of recombinant staphylokinase (r Sak) and the changes of fibrinolytic activity in the systemic circulation in the treatment of experimental central retinal artery occlusion (CRAO). Methods The animal model of CRAO in 15 cats (30 eyes) was set up by laser irradiating a branch of central retinal artery after intravenous injection of 3% rose bengal,and then the arterial thrombi were dissolved by intravenous injection of r Sak and urokinase (UK).The patency of the arteries was evaluated by FFA.Moreover,the changes of fibrinolitic activity in the blood were examined by phlebotomizing. Results The model of CRAO was successfully set up.Four hours after injection of thrombolysis drugs,the completely reopened proportion in r Sak group was 100%,while in UK group the proportion was 60%.At the same time,no significant systemic fibinnolytic activation was observed in r Sak group. Conclusions An experimental CRAO model,which has the similar pathological processes of occlusion of central retinal artery and intraarterial thrombosis as those in clinic,can be set up by using photochemical method,and r Sak is capable of lysing thrombus without significant activation of circulating plasminogen.