[1]李永东,赵俊功,李明华,等.大剂量人体白蛋白和硫酸镁对溶栓后脑组织的保护与促进修复作用[J].介入放射学杂志,2008,(08):578.
 LI Yongdong,ZHAO Jungong,LI Minghua,et al.Protection and repair of post-thrombolytic brain tissue with high-dose human albumin and magnesium sulfate:an experimental study[J].journal interventional radiology,2008,(08):578.
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大剂量人体白蛋白和硫酸镁对溶栓后脑组织的保护与促进修复作用()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2008年08期
页码:
578
栏目:
实验研究
出版日期:
2008-08-15

文章信息/Info

Title:
Protection and repair of post-thrombolytic brain tissue with high-dose human albumin and magnesium sulfate:an experimental study
作者:
李永东赵俊功李明华
200233上海交通大学附属第六人民医院介入影像科
Author(s):
LI Yong-dongZHAO Jun-gongLI Ming-huaYOU Xiao-fangCHEN Ying-sheng
Department of Diagnostic and Interventional Radiology,The Affiliated Sixth People's Hospital,Shanghai Jiaotong University,Shanghai200233,China
关键词:
急性脑缺血磁共振重组组织型纤溶酶原激活物硫酸镁人体白蛋白
分类号:
R743
文献标志码:
A
摘要:
目的评价rt-PA溶栓治疗联合大剂量人体白蛋白与硫酸镁延长溶栓时间窗的可能性和可靠性。方法健康雄性成年SD大鼠40只,对血栓法建立的急性大鼠大脑中动脉栓塞(MACO)模型随机分为4组。A组:缺血3h,rt-PA单纯溶栓(对照组,10只);B组:缺血6h,rt-PA单纯溶栓(10只);C组:缺血6h,rt-PA溶栓+人体白蛋白(10只);D组:缺血6h,rt-PA溶栓+人体白蛋白+硫酸镁(10只)。rt-PA(10mg /kg)与20%人体白蛋白(2.5g /kg)分别从大鼠股静脉缓慢注入,人体白蛋白在脑缺血3h开始注射,1h内完成;5%硫酸镁溶液(500mg /kg)在脑缺血3h和18h自腹腔注射。于治疗前、治疗后24h、7d、14d行MRI 检查,在治疗14d MRI 检查结束后立即处死,行病理学检查(包括光镜、电镜和免疫组化)、激光扫描共聚焦显微镜检查。结果①溶栓治疗后14d与治疗前比较,A、B、C、D4组中脑梗死体积分别缩小5.07%、2.58%、10.18%和35.40%,以D组缩小最为明显。②4组间梗死边缘区相对脑血流量(rCBV)在4个时间段分别比较差异均有统计学意义(P均<0.05)。③4组中大鼠的生存时间以D组最长,以B组最短,4组之间存活时间比较差异无统计学意义(F=0.188,P=0.904)。④激光扫描共聚焦显微镜显示C组、D组脑梗死边缘区微血管轻度扩张,有少量、局限的荧光物质渗出,较B组明显减少。⑤免疫组化显示C组与D组脑梗死边缘区胶质纤维酸性蛋白(GFAP)增生活跃,与B组比较增生层较厚且密集。⑥电镜结果显示C组、D组神经元核形态基本正常,线粒体轻度肿胀,星形细胞足板轻度空泡化,较B组损害程度轻。结论rt-PA溶栓治疗联合人体白蛋白、硫酸镁明显缩小脑梗死体积,提高脑梗死边缘区rCBV速率,促进星形细胞增生。研究表明rt-PA溶栓治疗联合大剂量人体白蛋白、硫酸镁,能有效地延长溶栓时间窗,可以延长至脑缺血6h内。

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备注/Memo

备注/Memo:
收稿日期:2007-07-31
基金项目:国家自然科学基金资助(编号:30470506)
更新日期/Last Update: 2008-08-15