南方医科大学学报 ›› 2018, Vol. 38 ›› Issue (09): 1089-.doi: 10.12122/j.issn.1673-4254.2018.09.11

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超声联合微泡溶解不同凝龄血栓后挽救缺血组织的效果

彭晓红,李海瑞,陈晓强,钟佳源,刘俭,曹世平   

  • 出版日期:2018-09-20 发布日期:2018-09-20

Efficacy of combined ultrasound and microbubble treatment for thrombolysis for rescuing ischemic tissues in rats at different time after thrombosis

  • Online:2018-09-20 Published:2018-09-20

摘要: 目的探索超声联合微泡通过溶解血栓挽救缺血组织的效果与血栓凝龄的关系。方法构建不同凝龄的大鼠髂总动脉血 栓模型,分为3、6和12 h组。采用二维及多普勒超声评价血管再通率,采用由声学造影法测定的平台期声强度(AI)评估后肢骨 骼肌微血管血容量,ELISA法定量骨骼肌损伤标记物肌红蛋白(Mb)和肌酸激酶(CK),TUNEL法检测骨骼肌细胞调亡率。结 果6 h 组、12 h 组分别与3 h 组比较,血管再通率和AI均降低,Mb、CK和骨骼肌细胞凋亡率均升高,差异均有统计学意义(P< 0.05);12 h 组与6 h 组比较,AI(6.98±0.76 vs 8.84±1.05 U)降低,Mb(101.29±8.92 vs 58.36±6.17 ng/mL)、CK(448.05±20.06 vs 269.99±17.66 U/L)和骨骼肌细胞凋亡率(27.51±0.43 % vs 20.40±0.51 %)升高,差异均有统计学意义(P<0.05)。结论超声联合 微泡溶解血栓后挽救缺血组织的效果随着血栓凝龄的增高而降低。

Abstract: Objective To explore the relationship between the time after thrombosis and the efficacy of combined ultrasound and microbubble treatment for rescuing the ischemic tissues. Methods Rat models of thrombosis in the right common iliac artery were established and received combined ultrasound and microbubble treatment at 3, 6 and 12 h after thrombosis. The recanalization rate of the right common iliac artery was assessed using both 2-dimensional and Doppler ultrasound. The plateau acoustic intensity (AI) was quantified for estimating the skeletal microvascular blood volume, and skeletal muscle injury markers including myoglobin (Mb) and creatinine kinase (CK) were measured using ELISA. Postmortem TUNEL staining was used to detect the apoptotic rate of skeletal muscle cells in the hind limb of the rats. Results Compared with those in 3 h group, the recanalization rate and AI were significantly lower, and the levels of Mb and CK and the apoptotic rate of the skeletal muscle cells were significantly higher in both 6 h group and 12 h group (P<0.05). Compared with those in 6 h group, the rats receiving treatment at 12 h after thrombosis showed significantly lowered AI and increased Mb, CK and apoptotic rate of the skeletal muscle cells (P<0.05). Conclusion The efficacy of combined ultrasound and microbubble treatment for rescuing ischemic tissues tends to be attenuated as the time after thrombosis prolongs in rats.