低强度超声联合微泡增强猪股静脉血栓溶栓效果的研究

Low-intensity ultrasound combined with microbubbles on augmenting thrombolytic effect of deep vein thrombosis in the hind legs of pigs

目的通过建立猪股静脉血栓模型,研究低强度超声联合血栓内持续灌注微泡的溶栓效果。方法将16个猪股静脉血栓模型随机分为2组进行溶栓治疗,一组使用低强度超声联合导管内持续灌注微泡和尿激酶治疗(UT+CDT组),另一组单纯使用尿激酶组治疗(CDT组)。行导管内血栓超声造影评估溶栓效果,行猪纤维蛋白原免疫荧光染色观察血栓内部纤维蛋白网结构的完整性。结果UT+CDT组有7例实现了血管再通,CDT组仅有2例实现再通,两组再通率的差异存在统计学意义(P=0.041)。免疫荧光染色显示UT+CDT组可见较多纤维蛋白网结构断裂,两组均未发生不良反应。结论在猪股静脉血栓模型中,低强度超声联合导管内持续灌注微泡能增强尿激酶的溶栓效果。

Objective To investigate the thrombolytic effect of low-intensity ultrasound combined with continuous perfusion of microbubbles inside the thrombus by establishing model of deep vein thrombosis(DVT)in the hind legs of pigs.Methods Sixteen models of DVT in the hind legs of pigs were randomly divided into two groups for thrombolytic therapy.UT+CDT group used low-intensity ultrasound combined with continuous perfusion of microbubbles and urokinase through the catheter,while CDT group used urokinase only.The outcome of thrombolytic therapy was evaluated by intra-catheter contrast-enhanced ultrasound,and the integrity of fibrin net structure was observed by porcine fibrinogen immunofluorescence staining.Results Recanalization was achieved in seven pigs in the UT+CDT group and only two in the CDT group.There was statistically significant difference of recanalization rate between the two groups(P=0.041).More broken fibrin was observed under immunofluorescence microscope in the UT+CDT group.No adverse reactions occurred in both groups.Conclusion In the model of DVT of porcine hind legs,low-intensity ultrasound combined with continuous perfusion of microbubbles through the catheter can enhance the thrombolytic effect of urokinase.