University of Oxford, Institute of Biomedical Engineering, Department of Engineering Science , Old Road Campus Research Building, Oxford OX3 7DQ , UK +44(0)1865 617 747 ;
Expert Opin Drug Deliv. 2014 Feb;11(2):187-209. doi: 10.1517/17425247.2014.868434. Epub 2014 Jan 9.
Ultrasound enhancement of thrombolysis (sonothrombolysis) is further potentiated by administration of acoustically active microbubbles, which may be developed into powerful adjuvant therapies for thrombolytic treatment of occlusive conditions such as ischaemic stroke.
The role of microbubbles in sonothrombolysis is evaluated based on published in vitro and in vivo evidence and a critical review of clinical trials to date. Microbubble, ultrasound and drug parameters compiled from a broad search of the existing literature are tabulated. Mechanisms of microbubble-enhanced sonothrombolysis are discussed, with particular focus on acoustic cavitation and thermal effects. A number of challenges to widespread clinical adoption are identified. Key factors for future optimisation of treatment and microbubble design are proposed.
Microbubble enhancement of thrombolysis is supported by a broad range of in vitro and in vivo evidence that demonstrates improved lysis compared to conventional drug treatment or ultrasound without microbubbles. Clinically, this is shown by accelerated recanalisation of occluded arteries; however, further research is needed to ensure patient safety. Before such techniques can enter widespread clinical practice, an improved understanding of the role of microbubbles in sonothrombolysis is required, in addition to demonstration of significant improvement over existing treatments and the development of reliable real-time monitoring protocols.
通过向血栓中注入声敏微泡来增强溶栓作用（声溶栓），这一方法进一步增强了溶栓效果，有望成为治疗闭塞性疾病（如缺血性脑卒中）的一种强有力的辅助治疗方法。
本文基于已发表的体外和体内证据，以及对迄今为止的临床试验的批判性回顾，评估了微泡在声溶栓中的作用。从广泛的文献搜索中汇编了微泡、超声和药物参数。本文讨论了微泡增强声溶栓的机制，特别关注了声空化和热效应。本文还确定了广泛临床应用所面临的一些挑战，并提出了未来优化治疗和微泡设计的关键因素。
广泛的体外和体内证据表明，与传统药物治疗或无微泡的超声相比，微泡增强溶栓可提高溶栓效果。临床上，这表现为阻塞动脉更快地再通；然而，还需要进一步的研究来确保患者的安全。在这些技术广泛应用于临床实践之前，需要进一步了解微泡在声溶栓中的作用，以及在现有治疗方法的基础上显著提高治疗效果，并开发可靠的实时监测方案。
