Dvelopment of Intravascular Ultrasound System and Contrast Echo Agent Involving Thrombolytic Agent for the Treatment of Acute Myocardial Infarction

血管内超声系统及超声造影剂联合溶栓剂治疗急性心肌梗死的研制

基本信息

批准号：
09557061
负责人：
MATSUO Hirohide
金额：
$ 6.27万
依托单位：
Kagawa Medical University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
1997
资助国家：
日本
起止时间：
1997 至 1998
项目状态：
已结题

项目摘要

Background. Although the enhancement of tissue plasminogen activator (tPA) induced thrombolysis by ultrasound has been reported to be augmented by ultrasound contrast agents (UCA), few data exist regarding its process.Objectives. We evaluated the effect of a galactose based UCA, on the efficacy of ultrasonic enhancement of tPA thrombolysis and observed serial change in acoustic property and histopathology for the implication of its process.Method. We employed a catheter-type transducer capable of ultrasound emission in both continuous (CW) and pulsed wave (PW). The tPA thrombolysis was studied in 30 artificial white thrombus which were assorted to 4 study groups based on insonation modes and with and without UCA.Each sample was suspended in 100 mL saline in a beaker. Five minutes after tPA (8000 U) administration, ultrasound was applied for 10 minutes. For the UCA treated groups, UCA (0.25 g) was added 5 minutes after the start of ultrasound exposure. The alteration of the thrombus was monitored with echography.Results. Weight reduction of the thrombus was -25*6% in tPA+PW and -30*7% in tPA+CW, which was significantly enhanced by UCA treatment, -40*3% (p<0.001) in tPA+PW+UCA and -43*7% (p<0.001) in tPA+CW+UCA.Area of thrombus echo image minimally decreased with ultrasound alone (-12*6% : tPA+PW, -23*11% : tPA+CW). In UCA groups, UCA induced a remarkable reduction of size (-36*3% : tPA+PW+UCA, -43*7% : tPA+PW+UCA) with a high echo intensity in the superficial layer of thrombus, where multiple cavity formation was observed by light microscope.Conclusions. UCA markedly enhanced the effect of ultrasound on tPA thrombolysis. The altered acoustic property and corresponding histological microcavity formation in the shallow layer within the thrombus suggests that UCA augmented infiltration of tPA into the thrombus.

背景。尽管据报道，超声对比剂（UCA）增强了组织纤溶酶原激活剂（TPA）诱导的溶栓的增强，但有关其过程的数据很少。我们评估了基于半乳糖的UCA的影响，对TPA溶栓的超声增强的功效，并观察到声学特性和组织病理学的串行变化对其过程的影响。我们使用了能够在连续（CW）和脉冲波（PW）中进行超声发射的导管型换能器。在30个人造白血栓中研究了TPA溶栓分解，这些血栓形成了基于插件模式的4个研究组，并且有或没有UCA。 TPA（8000 U）给药五分钟后，将超声检查10分钟。对于经过UCA处理的组，在超声曝光开始后5分钟添加UCA（0.25 g）。用echography.ults监测血栓的变化。 Weight reduction of the thrombus was -25*6% in tPA+PW and -30*7% in tPA+CW, which was significantly enhanced by UCA treatment, -40*3% (p<0.001) in tPA+PW+UCA and -43*7% (p<0.001) in tPA+CW+UCA.Area of thrombus echo image minimally decreased with ultrasound alone （-12*6％：TPA+PW，-23*11％：TPA+CW）。在UCA组中，UCA引起了尺寸的显着降低（-36*3％：TPA+PW+UCA，-43*7％：TPA+PW+UCA），在血栓表面的浅层层中具有较高的回波强度，在该层中观察到多个腔体形成了多腔。 UCA显着增强了超声对TPA溶栓的影响。在血栓中浅层层中的声学特性和相应的组织学微腔形成表明，UCA扩大了TPA渗透到血栓中。