Roessler Florian C, Schumacher Sabrina, Sprenger Andreas, Gärtner Ulrich, Al-Khaled Mohamed, Eggers Jürgen
Department of Neurology, Justus Liebig University Giessen, Giessen, Germany.
J Vasc Res. 2016;53(3-4):128-137. doi: 10.1159/000449386. Epub 2016 Oct 7.
Patients with acute ischemic strokes frequently take an acetylsalicylic acid (ASA) premedication. We determined the impact of ASA on different thrombolysis strategies in vitro.
For two clot types made from platelet-rich plasma (one with and one without ASA) lysis rates were measured by weight loss after 1 h for five different groups: in control group A clots were solely placed in plasma; in groups B and C clots were treated with rt-PA (60 kU/ml), and in groups D and E clots were treated with desmoteplase (DSPA; 2 µg/ml). Ultrasound (2 MHz, 0.179 W/cm2) was included in groups C and E. The fibrin mesh structures of the clots were investigated by electron microscopy.
For both clot types lysis rates increased significantly for all treatment strategies compared to their control group (each p < 0.001). The addition of ASA significantly increased the lysis rate in all 5 groups (each p < 0.001) and led to a ceiling effect concerning the treatment. A semiquantitative analysis of transmission electron micrographs revealed a decreased fibrin density for clots with ASA. For both clot types DSPA and ultrasound led to a significant dissolution of the fibrin mesh (both p = 0.029).
In vitro ASA pretreatment leads to significantly increased lysis rates due to a weaker fibrin mesh in platelet-rich plasma clots.
急性缺血性脑卒中患者常服用乙酰水杨酸（ASA）进行预处理。我们在体外确定了ASA对不同溶栓策略的影响。
对于由富含血小板血浆制成的两种凝块类型（一种含ASA，一种不含ASA），在五个不同组中于1小时后通过重量减轻测量溶解率：在对照组A中，凝块仅置于血浆中；在B组和C组中，凝块用重组组织型纤溶酶原激活剂（rt-PA；60 kU/ml）处理，在D组和E组中，凝块用去氨普酶（DSPA；2 μg/ml）处理。C组和E组使用超声（2 MHz，0.179 W/cm2）。通过电子显微镜研究凝块的纤维蛋白网状结构。
与各自的对照组相比，对于两种凝块类型，所有治疗策略的溶解率均显著增加（每组p < 0.001）。添加ASA显著提高了所有5组的溶解率（每组p < 0.001），并导致治疗出现上限效应。对透射电子显微镜图像的半定量分析显示，含ASA的凝块纤维蛋白密度降低。对于两种凝块类型，DSPA和超声均导致纤维蛋白网显著溶解（两者p = 0.029）。
在体外，由于富含血小板血浆凝块中的纤维蛋白网较弱，ASA预处理导致溶解率显著提高。
