Ultrasonic Department, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
Ultrasonic Department, Huashan Hospital, Fudan University, Shanghai 200040, China.
Thromb Res. 2015 Nov;136(5):1027-32. doi: 10.1016/j.thromres.2015.08.027. Epub 2015 Sep 5.
To investigate the efficacy of transcranial color Doppler ultrasound (TCCS) combined with microbubbles (MBs) and rt-PA (recombinant tissue plasminogen activator) for thrombolysis in vivo.
An arterial embolization model was established in Sprague-Dawley rats by retrograde placement of autologous thrombi into the common carotid artery followed by ligation of external carotid artery and temporary occlusion of the carotid artery and internal carotid artery by clamping. The animals were divided into 5 groups with 6 rats in each group: ① untreated control group, ② rt-PA group, ③ TCCS+MBs group, ④ TCCS+MBs+rt-PA group, ⑤ TCCS+MBs+1/2 rt-PA+group. Thrombolytic effects including recanalization rate and recanalization grade were evaluated with grayscale and color Doppler ultrasound post treatment. Examination of histological change in the involved vessel was performed at the end of the experiments.
Thrombolysis in terms of recanalization rate and recanalization grade was observed in the treated groups in a time-dependent manner, except the TCCS+MBs group. Addition of rt-PA remarkably enhanced the therapeutic lysis in TCCS+MBs group. However, no difference of therapeutic effects existed between TCCS+MBs+rt-PA group and TCCS+MBs+1/2 rt-PA group.
TCCS+MBs combined with rt-PA is a relatively effective approach for ischemic arterial thrombosis with an additive or synergistic effect.
探讨经颅彩色多普勒超声（TCCS）联合微泡（MBs）和 rt-PA（重组组织型纤溶酶原激活剂）体内溶栓的疗效。
通过将自体血栓逆行放置在颈总动脉中，并结扎颈外动脉和通过夹闭临时闭塞颈总动脉和颈内动脉，在 Sprague-Dawley 大鼠中建立动脉栓塞模型。将动物分为 5 组，每组 6 只：①未治疗对照组，②rt-PA 组，③TCCS+MBs 组，④TCCS+MBs+rt-PA 组，⑤TCCS+MBs+1/2 rt-PA 组。治疗后通过灰阶和彩色多普勒超声评估溶栓效果，包括再通率和再通等级。实验结束时对受累血管的组织学变化进行检查。
除 TCCS+MBs 组外，治疗组的溶栓效果（再通率和再通等级）均呈时间依赖性。加入 rt-PA 可显著增强 TCCS+MBs 组的治疗性溶栓作用。然而，TCCS+MBs+rt-PA 组和 TCCS+MBs+1/2 rt-PA 组之间的治疗效果没有差异。
TCCS+MBs 联合 rt-PA 是一种相对有效的治疗缺血性动脉血栓形成的方法，具有相加或协同作用。
