Kolts R L, Maki H S, Kuehner M E, Roberts R C, Sautter R D
Department of Surgery, Marshfield Clinic, WI 54449.
J Invest Surg. 1989;2(4):431-6. doi: 10.3109/08941938909018268.
Heparin potentiation of clot lysis by streptokinase was studied in a rabbit model. Clot was initiated in the rabbit aorta with stasis and thrombin and allowed to naturally propagate proximally until stasis met flow. The clot was allowed to age for 1 h before assigning treatment. Fifteen rabbits (group I) were given streptokinase (10,000 IU/h) and 11 rabbits (group II) were given streptokinase (10,000 IU/h) plus sodium-heparin (120 IU/h). Thrombolytic therapy was continued for 5 h. Clot lysis averaged 30% in group I and 70% in group II. Ten of 11 rabbits in group II had more than 50% clot lysis, whereas only 4 of 15 in group I had this degree of lysis. One group II rabbit and four group I rabbits died prematurely; each was noted to have clot propagation at the time of death. While a trend for amelioration of hypofibrinogenemia was observed in the group receiving both streptokinase and heparin, this difference was not statistically significant. We conclude, in the animal model, that thrombolysis by a combination of heparin and streptokinase is more effective than streptokinase alone. Systemic effects are apparently no worse with the combination.
在兔模型中研究了肝素对链激酶溶栓作用的增强效果。在兔主动脉中通过血流淤滞和凝血酶启动血栓形成，并使其向近端自然扩展，直至淤滞处与血流相遇。在给予治疗前，让血栓形成1小时。15只兔子（第一组）给予链激酶（10,000 IU/h），11只兔子（第二组）给予链激酶（10,000 IU/h）加肝素钠（120 IU/h）。溶栓治疗持续5小时。第一组的血栓溶解平均为30%，第二组为70%。第二组11只兔子中有10只血栓溶解超过50%，而第一组15只中只有4只达到此溶解程度。第二组有1只兔子和第一组有4只兔子过早死亡；每只在死亡时均有血栓扩展。虽然在同时接受链激酶和肝素的组中观察到纤维蛋白原血症改善的趋势，但这种差异无统计学意义。我们得出结论，在该动物模型中，肝素和链激酶联合溶栓比单独使用链激酶更有效。联合使用的全身效应显然并不更差。
