Harris K A, Carroll S E, Derose G, Jamieson W G, Kozak R, Meads G E, Sweeney J P
Department of Surgery, University of Western Ontario, London.
Int Angiol. 1994 Dec;13(4):331-5.
This paper studies the effect of three doses of Streptokinase infused intra-operatively into an animal model of small vessel thrombosis.
This is a controlled trial of intraoperative infusion of thrombolytic agent into a thrombosed arterial segment compared to no infusion into the contralateral limb.
19 New Zealand White rabbits were stratified into 3 groups.
Thrombosis was achieved by infusing a mixture of topical thrombin and autologous blood into individual iliac arteries of the New Zealand white rabbit. A randomly selected hind limb had an infusion of one of three doses of streptokinase (A = 2,500u; B = 5,000u; C = 10,000u) in saline over 20 minute period. Preinfusion and post infusion angiography was performed.
Angiograms were ranked by a radiologist blinded to the side of infusion and clotting parameters were assessed.
All limbs at all doses of streptokinase infusion (SK) showed significant clot lysis when compared to the non-infused limb(C). The percentage of improved segments is as follows: iliac: SK = 100%, C = 79%; femoral SK = 79%, C = 32%; tibial SK = 52%, C = 5%. Although there was an elevation in clotting time and a reduction in fibrinogen, levels remained within normal limits.
Streptokinase infused directly into thrombus in arteries even in low doses significantly enhances thrombolysis of vessels which are too small to be cleared by mechanical means. No significant systemic complications were encountered.
本文研究术中向小血管血栓形成的动物模型输注三种剂量链激酶的效果。
这是一项对照试验，将溶栓剂术中输注到血栓形成的动脉节段，与对侧肢体不进行输注作比较。
19只新西兰白兔被分为3组。
通过向新西兰白兔的各条髂动脉内输注局部凝血酶和自体血的混合物来形成血栓。随机选择一侧后肢在20分钟内输注三种剂量链激酶（A = 2500单位；B = 5000单位；C = 10000单位）中的一种，溶剂为生理盐水。在输注前和输注后进行血管造影。
由对输注侧不知情的放射科医生对血管造影进行评级，并评估凝血参数。
与未输注链激酶的肢体（C组）相比，所有剂量链激酶输注（SK）的肢体均显示出显著的血栓溶解。改善节段的百分比情况如下：髂动脉：SK组 = 100%，C组 = 79%；股动脉SK组 = 79%，C组 = 32%；胫动脉SK组 = 52%，C组 = 5%。虽然凝血时间有所延长且纤维蛋白原有所减少，但各项指标仍在正常范围内。
即使低剂量直接向动脉血栓内输注链激酶也能显著增强对过小而无法通过机械手段清除的血管的溶栓效果。未出现明显的全身并发症。
