Hemorrhagic transformation following tissue plasminogen activator in experimental cerebral infarction.
Hemorrhagic transformation following tissue plasminogen activator in experimental cerebral infarction.
复制标题
DOI：
10.1161/01.str.21.4.596
复制
发表时间：
1990-04
期刊：
影响因子：
8.3
通讯作者：
G. Zoppo;B. Copeland;James A. Koziol
中科院分区：
文献类型：
--
作者：
G. Zoppo;B. Copeland;James A. Koziol
在已建立的清醒非人灵长类动物（狒狒）模型中研究了静脉输注重组组织型纤溶酶原激活剂对大脑中动脉区域缺血后早期出血性转化的影响。在30只狒狒中的每只中，在大脑中动脉闭塞3小时和再灌注30分钟后，进行60分钟的重组组织型纤溶酶原激活剂（三种剂量：A组，0.3 mg/kg，n = 6; B组，1.5 mg/kg，n = 6; C组，10 mg/kg，n = 12）或生理盐水（n = 12）的输注。分别在24小时和10天通过计算机断层扫描、14天的神经病理学和连续的每日神经学评估来确定脑出血的频率和体积、梗死体积和临床变化。外周（非颅内）出血（A组，p = 0.46; B组，p = 0.015; C组，p = 0.002）和血浆组织型纤溶酶原激活剂峰值水平与重组组织型纤溶酶原激活剂剂量直接相关。瘀点性出血性梗死是30只狒狒中常见的发现。与相应生理盐水处理的狒狒相比，任何组中梗死相关出血的发生率或体积均无显著差异。在汇总数据中，出血量和梗死体积之间没有显著关系。我们得出结论，出血性转化的发生率和严重程度与梗死面积无关，在该模型中，局灶性脑缺血发作后早期（小于或等于3.5小时）给予重组组织型纤溶酶原激活剂不会增加出血的发生率或严重程度（体积）。
The effect of an intravenous infusion of recombinant tissue plasminogen activator on hemorrhagic transformation early after middle cerebral artery territory ischemia was studied in an established awake nonhuman primate (baboon) model. Following 3 hours' occlusion of the middle cerebral artery and 30 minutes' reperfusion in each of 30 baboons, a 60-minute infusion of recombinant tissue plasminogen activator (at three doses: Group A, 0.3 mg/kg, n = 6; Group B, 1.5 mg/kg, n = 6; Group C, 10 mg/kg, n = 6) or normal saline (n = 12) was undertaken. The frequency and volume of intracerebral hemorrhage, the volume of infarction, and clinical alterations were determined by computed tomography at 24 hours and 10 days, neuropathology at 14 days, and serial daily neurologic evaluations, respectively. Peripheral (nonintracranial) hemorrhage (Group A, p = 0.46; Group B, p = 0.015; Group C, p = 0.002) and peak plasma tissue plasminogen activator levels varied directly with the dose of recombinant tissue plasminogen activator. Petechial hemorrhagic infarction was a common finding among the 30 baboons. No significant differences in the incidences or volumes of infarction-related hemorrhage were apparent in any group compared with the respective saline-treated baboons. In pooled data, no significant relation between the volume of hemorrhage and the volume of infarction could be established. We conclude that the incidence and severity of hemorrhagic transformation are not related to infarction size and that recombinant tissue plasminogen activator does not increase the incidence or severity (volume) of hemorrhage when given early (less than or equal to 3.5 hours) after the onset of focal cerebral ischemia in this model.