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目的研究经颈动脉溶栓治疗对兔脑静脉窦血栓模型的局部脑血流量及脑含水量的影响。方法39只新西兰兔通过结扎法建立兔脑静脉窦血栓模型,分为溶栓组(12只,经颈动脉泵入尿激酶0·4万U·kg-1·d-1,共5d)、抗凝组(12只,颈外静脉泵入肝素2mg·kg-1·d-1,共5d)、对照组(15只,颈动脉泵入生理盐水)。应用激光多普勒仪检测治疗前后局部脑血流量的变化,同时测定脑含水量的变化。结果治疗后局部脑血流量较模型建立前基线的百分率,溶栓组(94·8%±0·3%)明显高于抗凝组(88·6%±0·3%)和对照组(80·9%±0·3%,均P<0·01),抗凝组与对照组比较差异有统计学意义(P<0·01);治疗后溶栓组脑含水量(78·9%±0·3%)低于抗凝组(81·8%±0·7%)和对照组(82·1%±1·0%,均P<0·05)。结论应用颈动脉注射尿激酶栓治疗静脉窦血栓效果肯定,即使治疗不能开通静脉窦,局部脑血流量及脑含水量仍有明显改善。
Objective To study the effects of carotid artery thrombolysis on regional cerebral blood flow and brain water content in rabbit models of venous sinus thrombosis. Methods Thirty-nine New Zealand rabbits were divided into thrombolytic group (12 rabbits, 0.48 U · kg-1 · d-1 urokinase via carotid artery for 5 days) by ligation. Anticoagulation group (12 rats, external jugular vein pump heparin 2mg · kg-1 · d-1, a total of 5d), control group (15, carotid artery infusion of saline). Changes of local cerebral blood flow before and after treatment were detected by laser Doppler, and the changes of brain water content were also measured. Results After treatment, the percentage of local cerebral blood flow before the establishment of model was significantly higher than that of the thrombolysis group (94.8% ± 0.3%) and the control group (88.6% ± 0.3%) 80.9% ± 0.3%, all P <0.01), the difference between the anticoagulation group and the control group was statistically significant (P <0.01); the cerebral water content in the thrombolytic group after treatment was 78.9 % ± 0.3%) were lower than those in the anticoagulation group (81.8% ± 0.7%) and the control group (82.1% ± 1.0%) (P <0.05). Conclusion Carotid artery injection of urokinase suppository for the treatment of venous sinus thrombosis certainly positive, even if the treatment can not open the sinus, local cerebral blood flow and brain water content still significantly improved.