体外治疗量超声对血栓溶解效应的影响

The effect of therapeutic ultrasound on thrombolysis in vitro

目的 探讨超声的溶栓效应以及其与尿激酶联用在溶栓方面的协同作用 ,并对其作用机制进行探讨。方法 应用体外制备血凝块测定不同超声声强 (净强度 0 3 8、1 0 5、1 75W cm2 )、不同尿激酶浓度(12 5、2 5 0、5 0 0、10 0 0U ml)、不同作用时间 (15、3 0、60、12 0min)下的溶栓率P =(W0 -W1 ) W0 ,确定最佳作用组合 ;测定不同组 :①单用生理盐水组 ;②单用超声组 ;③单用尿激酶组 ;④超声与尿激酶联用组的溶栓率、悬液纤维蛋白降解产物 (FDP)浓度及扫描电镜观察 ,以确定超声的溶栓效应 ,确定超声和尿激酶在溶栓方面的协同作用 ,并对其机制进行探讨。结果 超声 (净强度 1 75W cm2 )作用可使溶栓率显著增大 (P <0 0 5 ) ,悬液FDP含量显著增加 (P <0 0 5 ) ,随声强增大其溶栓率增大更加明显 (P <0 0 1) ;超声与尿激酶联用二者可产生协同作用 ,使溶栓率显著增大 (P <0 0 1) ,悬液FDP含量也显著增加 (P <0 0 1) ,随声强增大 ,其溶栓率亦增加得更加明显 (P <0 0 1)。扫描电镜观察可见 ,联合作用者 ,其纤维蛋白网络结构疏松 ,网路间空隙加大、增多 ,且内部纤维网与细胞间粘着减轻。结论 超声具有肯定的溶栓效应 ;超声与尿激酶联用在溶栓方面二者有协同作用。该作用随声强增大而更加明显。超声的溶栓?

Objective To investigate the thrombolytic effect of ultrasound and evaluate the synergism of the combined ultrasound and urokinase treatment. Methods Different ultrasound intensity (0.38, 1.05, 1.75 W/cm 2 ), different urokinase concentration (125, 250, 500, 1000 U/ml) and different action time (15, 30, 60, 120 min) were used in order to confirm the best combination to achieve the higher thromolytic rate of the prepared clot in vitro. The level of fibrinogen degradation product FDP was determined and scanning electron microscope was used to measure the thromolytic rate in four groups, which were the normal saline group, ultrasound group, uokinase group, ultrasound and urokinase combined group, in order to evaluate the thrombolytic effect of ultrasound and the synergistic effect of the ultrasound and urokinase on thrombolysis. Results Ultrasound (1.75 W/cm 2) significantly improved the thrombolytic rate ( P <0.05), and the blood level of FDP ( P < 0.05 ), this was especially true when higher ultrasound intensity was used. Conclusion Ultrasound can be favourably used to increase the thrombolytic rate, and the combination of ultrasound and urokinase may exert a synergictic effect , thus, may be helpful to enhance its therapeutic effect.