兔大脑中动脉栓塞模型的建立及初步应用*
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Intra-arterial thrombolysis with recombinant staphylokinase in a rabbit middle cerebral artery embolic stroke model
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    摘要:

    目的:建立兔大脑中动脉(MCA)栓塞模型,并应用重组葡萄球菌激酶(r-Sak)进行动脉内溶栓治疗。方法:新西兰兔15只,在脑血管数字减影造影(DSA)监测下,用自体血凝块注入颈内动脉,形成MCA栓塞模型,经颈内动脉分别灌注生理盐水10 ml,r-Sak 0.4 mg/kg及尿激酶(UK)4×104 IU/kg,以DSA造影及脑梗死范围、行为障碍评分评价溶栓治疗的效果;测定凝血指标及纤维蛋白原(Fg),观察药物对全身凝血与纤溶系统的影响。结果:r-Sak组栓塞血管溶通率100%(5/5),UK组溶通率40%(2/5)。两组脑梗死范围均显著缩小,行为障碍改善。UK组Fg明显下降,凝血酶时间、部分凝血活酶时间及凝血酶原时间延长,而r-Sak组则无变化。结论:在所建立的兔MCA栓塞模型上通过早期动脉内溶栓可改善动物行为障碍,缩小脑梗死范围;r-Sak较UK具有更强的溶血栓作用,并具有纤维蛋白特异性,不会引起系统纤溶亢进。

    Abstract:

    Objective: To establish a rabbit middle cerebral artery (MCA) embolic stroke model, and to study intra-arterial thrombolysis with recombinant staphylokinase (r-Sak) in this model. Methods: Fifteen rabbits were subjected to a model of RMCA embolic stroke by injected autologous clots into the right internal carotid arterial. Thirty minutes after embolization, the rabbits were treated with saline, r-Sak 0.4 mg/kg or urokinase (UK) 4×104 IU/kg intra-arterial. Digital subtraction angiograms were performed every thirty minutes. Results: RMCA were reopened 100%after injection of r-Sak vs 40%reopened after injection of UK (P<0.01). The ischemia and neurological impairment in both groups were limited. UK prolonged thromb in time, kaolin prothrombin time and prothrombin time, decreased fibrinogen whereas r-Sak did not influence these factors. Conclusion: In the rabbit model of MCA embolic stroke, r-Sak is fibrin-specific and is more effective in lysing embolic clots than UK.

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