组织型纤溶酶原激活剂治疗实验性视网膜下出血

Tissue plasminogen activator treatment of experimental subretinal hemorrhage.

作者信息

Lewis H, Resnick S C, Flannery J G, Straatsma B R

机构信息

Jules Stein Eye Institute, Los Angeles, CA 90024-7007.

出版信息

Am J Ophthalmol. 1991 Feb 15;111(2):197-204. doi: 10.1016/s0002-9394(14)72259-7.

DOI:10.1016/s0002-9394(14)72259-7

PMID:1899537

Abstract

To determine if tissue plasminogen activator, a clot-specific fibrinolytic agent, could eventually be used to assist in the clearance or removal of subretinal hemorrhage, we studied the effect of subretinal injections of tissue plasminogen activator, autologous blood, balanced salt solution, and the combination of either tissue plasminogen activator or balanced salt solution after subretinal injection of autologous blood on retinal morphologic characteristics and clearance of subretinal hemorrhage in the albino rabbit. No morphologic evidence of tissue plasminogen activator toxicity was found in the rabbit retina at a dose of 25 to 50 micrograms/0.1 ml. Subretinal hemorrhage cleared faster after subretinal injection of tissue plasminogen activator when compared to balanced salt solution (P = .0005) but did not completely prevent overlying retinal degeneration. Both tissue plasminogen activator and balanced salt solution were found to decrease the toxic effects of subretinal blood on the morphologic characteristics of the rabbit retina, and this effect can be explained at least partly by dilution of the subretinal blood.

摘要

为了确定组织型纤溶酶原激活剂（一种凝块特异性纤溶药物）最终是否可用于辅助清除视网膜下出血，我们研究了视网膜下注射组织型纤溶酶原激活剂、自体血、平衡盐溶液，以及在视网膜下注射自体血后再注射组织型纤溶酶原激活剂或平衡盐溶液的组合对白化兔视网膜形态特征和视网膜下出血清除情况的影响。在剂量为25至50微克/0.1毫升时，在兔视网膜中未发现组织型纤溶酶原激活剂毒性的形态学证据。与平衡盐溶液相比，视网膜下注射组织型纤溶酶原激活剂后视网膜下出血清除得更快（P = .0005），但并未完全防止上方视网膜变性。发现组织型纤溶酶原激活剂和平衡盐溶液均可降低视网膜下血液对兔视网膜形态特征的毒性作用，并且这种作用至少部分可通过视网膜下血液的稀释来解释。