Ding Guangliang, Jiang Quan, Li Lian, Zhang Li, Zhang Zheng G, Panda Swayamprava, Ewing James R, Chopp Michael
Department of Neurology, Henry Ford Health Sciences Center, 2799 West Grand Boulevard, Detroit, MI 48202, USA.
J Neurol Sci. 2006 Jul 15;246(1-2):139-47. doi: 10.1016/j.jns.2006.02.020. Epub 2006 Apr 19.
To test the hypothesis that combination treatment of embolic stroke with rtPA and statins improves the efficacy of thrombolytic therapy in rats. Rats subjected to embolic MCA occlusion (MCAo) were randomized into control (n = 10) and treatment (n = 9) groups. Four hours after MCAo, a combination of rtPA and atorvastatin (treatment) or saline (control) was administered. MRI measurements were performed on all animals at 2 h, 24 h and 48 h after MCAo. The patency of cerebral microvessels was examined using fluorescent microscopy. MRI images showed complete blockage of the right MCA and a reduction of CBF in the territory supplied by the MCA 2 h after MCAo for all animals. By 48 h after stroke, MRI showed that the decreased lesion size, elevated CBF and increased incidence of recanalization were found in treated rats compared with the control rats. The combination treatment significantly increased microvascular patency (16.3 +/- 5.5% vs. 12.4 +/- 3.5%, of field-of-view) and reduced the infarct volume (23.1 +/- 9.6% vs. 38.8 +/- 13.3%, of hemisphere). These data demonstrate that the co-administration of rtPA and atorvastatin 4 h after ischemia is efficacious and is reflected by the MRI indices of recanalization of the MCA, reduction of secondary microvascular perfusion deficits and reduction of the ischemic lesion.
为验证rtPA与他汀类药物联合治疗栓塞性中风可提高大鼠溶栓治疗效果这一假说。将接受大脑中动脉栓塞闭塞(MCAo)的大鼠随机分为对照组(n = 10)和治疗组(n = 9)。MCAo后4小时,给予rtPA与阿托伐他汀联合用药(治疗组)或生理盐水(对照组)。在MCAo后2小时、24小时和48小时对所有动物进行MRI测量。使用荧光显微镜检查脑微血管的通畅情况。MRI图像显示,所有动物在MCAo后2小时,右侧大脑中动脉完全堵塞,且大脑中动脉供血区域的脑血流量减少。中风后48小时,MRI显示,与对照组大鼠相比,治疗组大鼠的病变大小减小、脑血流量升高且再通发生率增加。联合治疗显著提高了微血管通畅率(视野的16.3±5.5%对12.4±3.5%),并减少了梗死体积(半球的23.1±9.6%对38.8±13.3%)。这些数据表明,缺血后4小时联合给予rtPA和阿托伐他汀是有效的,且可通过大脑中动脉再通的MRI指标、继发性微血管灌注缺陷的减少以及缺血性病变的减少来体现。