其特点是只活化已和血栓结合之胞浆素原对纤维蛋白具有高度选择性.ppt

* 利用核磁共振檢測 * 無論於2.5或24小時利用MRI檢測皆可發現給予高壓氧氣治療可顯著減少BBB的損傷。 * * 1.氧氣治療只影響梗塞面積的大小 2.給予氧氣治療對於溶栓後再灌流的情形可以減少出血的面積及頻率 3.給予氧氣治療可以減少早期BBB滲透的情況，這可以做為溶栓後出血性併發症的marker 4.可以改善微血管完整性，即使該部位已經發生梗塞的情形 * 除了,tPA的治療外，最近也有許多研究將高壓氧列入輔助中風的治療 那麼什麼是高壓氧呢？ * Thus, both NBO and HBO induced a significant reduction in macroscopic hemorrhage on T2* MR image. The area of hypointense T2* signal at 24 hours after MCAO was located within the area of intense postcontrast enhancement on T1w images at 2.5 hours after MACO. In TT-t MCAo and CT-tMCAO, HBO significantly decreased the mean hemoglobin volume. Early increase in BBB permeability appeared to indicate a risk for later secondary hemorrhage. HBO significantly reduces infarct volume, BBB permeability, hemorrhage and MMP-9 activity after thrombolysis . SUMMARY 3 * Conclusion * Oxygen therapy can decrease infarct size and BBB damage after thromboembolic ischemia and reduce postthrombolytic intracerebral hemorrhage. * Thank you for attention * Oxygen therapy in combination with thrombolytic therapy only affects infarct size if recanalization is successful. Oxygen therapy reduce size and frequency of gross parenchymal hemorrhage after thrombolysis- induced reperfusion. HBO and NBO reduce early BBB permeability after tMCAO, which is a marker for subsequent hemorrhagic complications of thrombolysis. Oxygen therapy improves microvascular integrity even in regions that undergo parenchymal infarction * 缺血性中風阻塞之機轉不同可分為腦血栓(cerebral thrombosis)腦血栓原發於血管壁，因血液凝固(coagulation)而阻塞，並不移動 。腦栓塞(cerebral embolism)而腦栓塞則是血管壁沒有太大的問題，乃血管上游的漂流物漂下來把血管阻塞。 cerebral thrombosis cerebral embolism * 血栓的種類與溶解血栓的種類 一、血栓的種類 ??1.靜脈血栓 由於靜脈流速慢、血壓低。 血栓之成因是活化纖維蛋白、攔住血球細胞形成，因為有紅血球的參與，故呈現紅斑狀。 臨床以抗凝血劑為主。 ?? 2.動脈血栓 動脈管壁厚而有彈性，血流速度變快、血液壓力大。 血栓的形成主要是因血小板附著凝集。 臨床以抗血小板藥物為主。 ?? ?? * 抗血栓藥物 1.抗凝血劑(anticoagulant drugs) 2.血栓溶解藥物(thrombolytic drugs) 3.抗血小板藥物(antiplatelet drugs) * 血液凝固路徑及抗凝血藥物的作用部位 * 血栓的溶解機制 ?? 人體內有一連串的血栓