溶栓治疗时间窗与ICAM-1表达及白细胞浸润的关系

The relationship among ICAM-1 expression,leukocytes infiltration and thrombolytic therapeutic time windows in a rat embolic stroke model

目的 探讨不同溶栓治疗时间窗与细胞间粘附分子 - 1(ICAM 1)表达及白细胞浸润的关系。方法 采用自体血栓栓塞大脑中动脉 ,缺血 0 .5小时、1小时或 4小时开始溶栓治疗 ,应用免疫组织化学方法 ,观察缺血 12小时或 2 4小时ICAM 1的表达、白细胞的浸润程度 ;TTC染色测定梗死灶的大小。结果 缺血12小时和 2 4小时 ,4小时溶栓组较 0 .5小时和 1小时溶栓组梗死灶体积明显增大 (P <0 .0 1) ;缺血周边区I CAM 1面密度、浸润白细胞数增多 (P <0 .0 1) ;1小时溶栓组较 0 .5小时溶栓组梗死灶体积增大 (P <0 .0 5 ) ;浸润的白细胞数无显著性差异 (P >0 .0 5 ) ,但ICAM 1面密度增加 (P <0 .0 5 )。缺血 2 4小时与缺血 12小时比较 ,0 .5小时溶栓组ICAM 1面密度减少 (P <0 .0 5 ) ;而 1小时和 4小时溶栓组明显增加 (P <0 .0 5 ,P <0 .0 1)。结论 超早期溶栓治疗可以减少缺血周边区ICAM 1表达及白细胞的浸润 ;白细胞浸润参与了溶栓治疗后的病理生理过程。

Objective To evaluate the relatioship among ICAM 1 expression, leukocytes infiltration and thrombolytic therapeutic time window in a rat embolic stroke model.Methods The MCA was embolized by autogenous thrombi and at 0.5 h , 1 h or 4 h after ischemia, urokinase was administered through the catheter in ECA. ICAM 1 expression and leukocyte infiltration were evaluated using immunohistochemistry, and infarct size was calculated by TTC staining, at 12 h or 24 h after ischemia.Results After 12 h and 24 h ischemia, infarct volume, dense of ICAM 1 and number of leukocytes were all significantly reduced in 0.5h and 1h thrombolysis groups compared with those in 4h thrombolysis groups( P < 0.01 , P < 0.01 , P < 0.01 respectively), and these parameters except the number of leukocytes were significantly reduced in 0.5h thrombolysis group compared with those in 1h thrombolysis groups. The dense of ICAM 1 were lesser in 0.5h group, but greater in 1h and 4h thrombolysis groups after 24h ischemia than that of 12h ischemia( P < 0.05 , P < 0.01 ).Conclusions Ultra earlier thrombolysis could reduce ICAM 1 expression and leukocytes infiltration in margin of ischemia. Leukocytes infiltration contributed to the pathophysiology of thrombolytic therapy.