Levy E A, Sadove A M, Eppley B L, Evan A P
Department of Surgery, Indiana University Medical Center, Indianapolis 46202.
J Reconstr Microsurg. 1991 Jul;7(3):209-16. doi: 10.1055/s-2007-1006781.
A comparison was made between several characteristics of tissue-type plasminogen activator (t-PA) and urokinase (UK), potentially useful in microsurgery to restore perfusion to ischemic free-tissue transfers. An intraarterial infusion of one of the drugs (or normal saline [NS] as a control) was performed in conjunction with a rat femoral vein clot model. Both t-PA and urokinase were effective in lysing 100 percent of the venous clots on the side of infusion. This occurred in only 25 percent of controls (p = .0035). Thrombolysis on the contralateral side, a measure of systemic effect, occurred in 38 percent, 50 percent, and 13 percent of veins using t-PA, UK, and NS, respectively (t-PA vs. UK p = 1.0, t-PA vs. NS p = .28, UK vs. NS p = .14). Rethrombosis occurred in 13 percent and 25 percent of ipsilateral veins treated with t-PA and urokinase, respectively, and in one of the two veins that had resumed flow during saline infusion (t-PA vs. UK p = .30) Scanning electron microscopy was performed 4 hr and 48 hr after thrombolysis. No differences between thrombolytic agents was noted in terms of residual thrombus and vessel characteristics. The data suggest that t-PA and urokinase are effective, with no clear advantage of one agent over the other.
对组织型纤溶酶原激活剂（t-PA）和尿激酶（UK）的几个特征进行了比较，它们在显微外科手术中可能有助于恢复缺血性游离组织移植的灌注。在大鼠股静脉血栓模型中，同时进行了一种药物（或生理盐水[NS]作为对照）的动脉内输注。t-PA和尿激酶都能有效溶解输注侧100%的静脉血栓。而在对照组中只有25%出现这种情况（p = 0.0035）。对侧的溶栓情况（衡量全身效应的指标），分别在使用t-PA、UK和NS的静脉中，有38%、50%和13%发生（t-PA与UK相比，p = 1.0；t-PA与NS相比，p = 0.28；UK与NS相比，p = 0.14）。用t-PA和尿激酶治疗的同侧静脉中，分别有13%和25%发生再血栓形成，在生理盐水输注期间恢复血流的两条静脉中有一条发生再血栓形成（t-PA与UK相比，p = 0.30）。溶栓后4小时和48小时进行扫描电子显微镜检查。在残留血栓和血管特征方面，未发现溶栓剂之间存在差异。数据表明，t-PA和尿激酶都是有效的，且一种药物相对于另一种药物没有明显优势。
