人尿激肽原酶对急性脑梗死侧支循环与#br# 脑血流灌注影响的多模态MRI研究

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Abstract Objective: To explore the impact of human urinary kallidinogenase(HUK) on collateral circulation and blood perfusion in patients with acute cerebral infarction in order to find a new kind of medicine with great efficiency in building collateral circulation and saving ischaemic penumbra. Methods: Forty patients with acute cerebral infarction of middle cerebral artery(MCA) were selected in the study and divided into two groups with the randomized controlled method. Each group included twenty patients. Diffusion weighted imaging(DWI) and perfusion weighted imaging(PWI) images of all the participants were collected one day before treatment, the seventh day and the thirtieth day after treatment. We first compared the differences of blood perfusion in ischaemic core and ischaemic penumbra before and after treatment between the two groups. Then we compared the establishment of collateral circulation in peripheral regions of infarction between the two groups using contrast enhance MRA(CE-MRA) technology. Results: ①Compared with before treatment, the regional cerebral blood flow(rCBF) value in ischaemic core and ischaemic penumbra of both the groups increased significantly after treatment. However, group with HUK treatment had a more obvious increase of rCBF value in ischaemic tissues and the differences of rCBF value after treatment between the two groups are statistically significant(ischaemic core: 0.86±0.43 vs 0.54±0.13, P<0.05; ischaemic penumbra: 2.11±0.36 vs 1.03±0.61, P<0.05). ②Using CE-MRA, the establishment of leptomeningeal collateral circulation in lateral fissure and lateral surface of hemishere was showed and the grade of collateral circulation in group with HUK treatment improved significantly(4.3±0.5 vs 3.2±0.7, P<0.05). Conclusion: HUK can efficiently improve collateral circulation and blood perfusion of ischaemic tissues in patients with acute cerebral infarction. CE-MRA technology is likely to be a new method for evaluating the establishment of collateral vessels.

Key words： Brain infarction Urinary plasminogen activator Collateral circulation Magnetic resonance imaging

Received: 06 July 2015

PACS:
	Ｒ743.33
	Ｒ445.2

Corresponding Authors: HAN Ying

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http://www.jccmi.com.cn/EN/ OR http://www.jccmi.com.cn/EN/Y2016/V27/I2/77

[1]Strong K, Mathers C, Bonita R. Preventing stroke: saving lives around the world[J]. Lancet Neurol, 2007, 6(2): 182-187.
[2]Ding Z, Tong WC, Lu XX, et al. Hyperbaric oxygen therapy in acute ischemic stroke: a review[J]. Interv Neurol, 2014, 2(4): 201-211.
[3]Sandercock P, Wardlaw JM, Lindley RI, et al. The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke(the third international stroke trial[IST-3]): a randomised controlled trial[J]. Lancet, 2012, 379(9834): 2352-2363.
[4]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组. 中国急性缺血性脑卒中诊治指南2010[J]. 中国医学前沿杂志：电子版，2010，2（4）：50-59.
[5]Donnan GA, Baron JC, Ma H, et al. Penumbral selection of patients for trials of acute stroke therapy[J]. Lancet Neurol, 2009, 8(3): 261-269.
[6]Bang OY, Saver JL, Buck BH, et al. Impact of collateral flow on tissue fate in acute ischaemic stroke[J]. J Neurol Neurosurg Psychiatry, 2008, 79(6): 625-629.
[7]Wang YD, Lu RY, Huang XX, et al. Human tissue kallikrein promoted activation of the ipsilesional sensorimotor cortex after acute cerebral infarction[J]. Eur Neurol, 2011, 65(4): 208-214.
[8]Chao J, Chao L. Experimental therapy with tissue kallikrein against cerebral ischemia[J]. Front Biosci, 2006, 11: 1323-1327.
[9]Imamura T, Potempa J, Travis J. Activation of the kallikrein-kinin system and release of new kinins through alternative cleavage of kininogens by microbial and human cell proteinases[J]. Biol Chem, 2004, 385(11): 989-996.
[10]Ernst M, Forkert ND, Brehmer L, et al. Prediction of infarction and reperfusion in stroke by flow- and volume-weighted collateral signal in MR angiography[J]. Am J Neuroradiol, 2015, 36(2): 275-282.
[11]Moretti A, Ferrari F, Villa RF. Pharmacological therapy of acute ischaemic stroke: Achievements and problems[J]. Pharmacol Ther, 2015, 153: 79-89.
[12]Slevin M, Kumar P, Gaffney J, et al. Can angiogenesis be exploited to improve stroke outcome? Mechanisms and therapeutic potential[J]. Clin Sci(Lond), 2006, 111(3): 171-183.
[13]Hennerici MG, Kern R, Szabo K. Non-pharmacological strategies for the treatment of acute ischaemic stroke[J]. Lancet Neurol, 2013, 12(6): 572-584.
[14]张忠敏，郭艳芹，韩璎，等. 急性脑梗死侧支循环建立的神经影像学评估[J]. 医学研究生学报，2015，28（1）：85-88.
[15]Shuaib A, Butcher K, Mohammad AA, et al. Collateral blood vessels in acute ischaemic stroke: a potential therapeutic target[J]. Lancet Neurol, 2011, 10(10): 909-921.
[16]Griebe M, Kern R, Eisele P, et al. Continuous magnetic resonance perfusion imaging acquisition during systemic thrombolysis in acute stroke[J]. Cerebrovasc Dis, 2013, 35(6): 554-559.
[17]Chan PH. Future targets and cascades for neuroprotective strategies[J]. Stroke, 2004, 35(11 Suppl 1): 2748-2750.
[18]赵志斌. 人尿激肽原酶治疗急性缺血性脑卒中的效果[J]. 中国医药导报，2014，11（32）：68-71.
[19]辛秀峰，杨万勇，谭泽锋，等. 人尿激肽原酶对急性脑梗死侧枝循环的影响[J]. 中国神经精神疾病杂志，2011，37（1）：54-56.
[20]张建安. 人尿激肽原酶治疗急性脑梗死的临床与MR弥散灌注显像研究[D]. 广州：广州医学院，2009：1-55.
[21]Higashida RT, Furlan AJ, Roberts H, et al. Trial design and reporting standards for intra-arterial cerebral thrombolysis for acute ischemic stroke[J]. Stroke, 2003, 34(8): e109-137.
[22]杨志宏，伍建林. 磁敏感加权成像在显示脑梗死血栓中的临床应用价值[J]. 中国临床医学影像杂志，2011，22（12）：837-839.
[23]Kawel N, Valsangiacomo-Buechel E, Hoop R, et al. Preoperative evaluation of pulmonary artery morphology and pulmonary circulation in neonates with pulmonary atresia—usefulness of MR angiography in clinical routine[J]. J Cardiovasc Magn Reson, 2010, 12: 52.
[24]Yang JJ, Hill MD, Morrish WF, et al. Comparison of pre- and postcontrast 3D time-of-flight MR angiography for the evaluation of distal intracranial branch occlusions in acute ischemic stroke[J]. Am J Neuroradiol, 2002, 23(4): 557-567.