Tomaru T, Uchida Y, Sonoki H, Tsukamoto M, Sugimoto T
Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo, Japan.
Angiology. 1989 May;40(5):429-35. doi: 10.1177/000331978904000502.
To evaluate the thrombolytic effects of the native tissue-type plasminogen activator (t-PA), the authors used a thrombus model simulating clinical situations. The native t-PA (AK-124) was obtained from human-derived normal cells. Experimental canine coronary thrombosis was produced by partial constriction and endothelial denudation of the vessel. In 19 dogs, coronary occlusive thrombus was produced. Three hours after total occlusion of the coronary artery with thrombus, the authors attempted the thrombolytic therapy in 16 dogs. Histologically, three-hour thrombus was composed of a mixture of platelet aggregates, fibrin, and blood cells. They infused 0.375 mg/kg t-PA intravenously in 7 dogs and 20,000 IU/kg urokinase (UK) in 9. Coronary recanalization was achieved in 5 (71%) with t-PA infusion and 6 (67%) with UK infusion. Plasma fibrinogen levels decreased to 76% of preinfusion value in the dogs with t-PA infusion and to 34% in those with UK infusion. Coronary reocclusion occurred in 2 dogs with t-PA and 3 with UK. Thus, the native t-PA (AK-124) can provide coronary thrombolysis without severe depletion of plasma fibrinogen levels.
为评估天然组织型纤溶酶原激活剂(t-PA)的溶栓效果,作者使用了一种模拟临床情况的血栓模型。天然t-PA(AK-124)从人源正常细胞中获得。通过部分血管收缩和内皮剥脱制造实验性犬冠状动脉血栓形成。在19只犬中制造了冠状动脉闭塞性血栓。在用血栓使冠状动脉完全闭塞3小时后,作者对16只犬尝试进行溶栓治疗。组织学上,3小时的血栓由血小板聚集体、纤维蛋白和血细胞混合组成。他们给7只犬静脉输注0.375mg/kg的t-PA,给9只犬静脉输注20000IU/kg的尿激酶(UK)。输注t-PA的犬中有5只(71%)实现冠状动脉再通,输注UK的犬中有6只(67%)实现冠状动脉再通。输注t-PA的犬血浆纤维蛋白原水平降至输注前值的76%,输注UK的犬降至34%。2只输注t-PA的犬和3只输注UK的犬发生冠状动脉再闭塞。因此,天然t-PA(AK-124)可实现冠状动脉溶栓,而不会使血浆纤维蛋白原水平严重降低。