急性脑梗死溶栓后静点巴曲酶对凝血机制的影响.docVIP

　　急性脑梗死溶栓后静点巴曲酶对凝血机制的影响 作者：季建中 赵小祺 侯惠敏 李华 杨志峰 李冬梅 翟江 李银 曹宝森 【摘要】 目的： 研究 急性脑梗死家兔尿激酶溶栓后静点巴曲酶对凝血机制的 影响 。 方法 ：雄性健康新西兰大白兔随机分对照组、 治疗 1组、治疗2组。采用颈内动脉自血栓塞法建立脑梗死模型。治疗1组尿激酶静脉溶栓；治疗2组尿激酶溶栓后静点巴曲酶；对照组用等量生理盐水替代。分别测定不同时间段3组纤维蛋白原（FIB）、凝血酶原时间（PT）、活化部分凝血酶原时间（APTT）。治疗后22h断头取脑，冰冻切片观察有无脑出血，2%氯化三苯基四氮唑（TTC）染色观察有无脑梗死病灶。结果：治疗1、2组各有2例出血、TTC染色，治疗1组2例正常，治疗2组3例正常。对照组造模后FIB升高，PT、APTT缩短，与造模前比较差异有显著性（Plt;0.05）。治疗后6h，2个治疗组FIB下降，PT、APTT延???，与造模后2h或对照组比较，差异均有显著性（Plt;0.05），治疗2组FIB、PT、APTT与治疗1组比较，差异也有显著性（Plt;0.05）。结论：急性脑梗死家兔尿激酶溶栓后静点巴曲酶在一定剂量范围内是安全的,不增加出血发生率。通过凝血四项检测发现两药同时 应用 凝血机能下降明显，因此必须严格控制药物剂量，同时监测凝血—纤溶指标，减少出血事件发生。 【关键词】 脑梗死;尿激酶;巴曲酶 【ABSTRACT】 Objective: To investigate the influence of Batroxobin on the coagulative function to prevent reocclusion in the rabbit inistering Urokinase.Methods:18 healthy male Nely divided into three groups:1) model control;2) therapy group 1;3) therapy group 2. Each groups contained 6 animals. The rabbit models bolism to embolize the cerebral artery through intracervical artery.Rabbits in therapy group 1 e dosage of Urokinase plus 2.5BU/kg of Batroxobin;Rabbits in the model control al saline at the same dosage.Fibrinogen(FIB)、 prothrombin time (PT) and Activated partial thromboplastin time(APTT)easured in each group bosaeen400C grumemeter at different time:before model formation,2 hours after model formation;6hr after treatment;22hr after treatment.The brain tissues ent.Frozen sections orrhage,2%tetrazolium (TTC)dyeing orrhage both in group 1 and group 2.By the TTC dyeing,there al in group 1 and 3 cases normal in group 2.pared odeling,the FIB in model control group had increased,the PT and APTT had decreased after modeling,so there odeling or the same period of model control group,the FIB in group 1,2 had decreased obviously at 6 hours after treatment,arkably (Plt;0.05).pared ent,the FIB、PT and APTT in group 2 had changed greatly at the same time(Plt;0.05).Conclusion: Batroxobin is safe at the range of definite dosage in treating acute cerebral infarction after a