Arnljots B, Dougan P, Salemark L, Bergqvist D
Department of Plastic and Reconstructive Surgery, Malmö General Hospital, Sweden.
Scand J Plast Reconstr Surg Hand Surg. 1994 Mar;28(1):9-13. doi: 10.3109/02844319409015988.
The effects of streptokinase and urokinase on haemostasis, accumulation of platelets radiolabelled with phosphorus (32P) and patency were studied after arteriotomy and deep vessel wall trauma of the central arteries of rabbits' ears. In one study, 12 rabbits were given 1700 IU/kg body weight of streptokinase or urokinase as intraaortic bolus injections five minutes before vascular reperfusion (opening of vascular clamps). A further six were given saline (controls). In the second, 12 further rabbits were each given 3,400 IU/kg of either substance, one fifth as a bolus before reperfusion and the remainder as a continuous infusion during the next two hours. A further six were given saline (controls). Irrespective of the dosage regimens, neither substance improved patency compared with saline-treated controls. Separate dose response studies with streptokinase showed that bolus or bolus+infusion doses larger than those given caused troublesome arteriotomy bleeding. Compared with controls, streptokinase increased, and urokinase decreased, accumulation of platelets. This was not reflected in differences in patency rates, which were similar in all groups. In conclusion, fibrinolytic stimulation with non-thrombolytic doses of streptokinase or urokinase did not prevent microarterial thrombosis in rabbits. The therapeutic index for these substances in clinical microvascular surgery is probably low, as haemorrhagic complications may be expected.
在兔耳中央动脉进行动脉切开术和深层血管壁创伤后，研究了链激酶和尿激酶对止血、磷（³²P）标记血小板的聚集以及血管通畅性的影响。在一项研究中，12只兔子在血管再灌注（打开血管夹）前5分钟经主动脉推注给予1700 IU/kg体重的链激酶或尿激酶。另外6只给予生理盐水（对照组）。在第二项研究中，另外12只兔子每只给予3400 IU/kg的上述任何一种物质，五分之一作为再灌注前的推注剂量，其余在接下来的两小时内持续输注。另外6只给予生理盐水（对照组）。无论给药方案如何，与生理盐水处理的对照组相比，两种物质均未改善血管通畅性。对链激酶进行的单独剂量反应研究表明，推注或推注加输注剂量大于所给剂量会导致动脉切开处出血麻烦。与对照组相比，链激酶使血小板聚集增加，而尿激酶使其减少。这并未反映在通畅率的差异上，所有组的通畅率相似。总之，用非溶栓剂量的链激酶或尿激酶进行纤溶刺激并不能预防兔子的微动脉血栓形成。由于可能出现出血并发症，这些物质在临床微血管手术中的治疗指数可能较低。
