Bergstein J M
Department of Pediatrics, Indiana University School of Medicine, Indianapolis.
Kidney Int. 1989 Jan;35(1):14-8. doi: 10.1038/ki.1989.2.
To study the effect of tissue plasminogen activator (TPA) therapy on glomerular fibrin deposition in the generalized Shwartzman reaction, rabbits were given an intravenous injection of TPA immediately following or three, four, or five hours after the second injection of endotoxin. Animals were sacrificed six hours after the second dose of endotoxin. Glomerular fibrin deposition was reduced in animals receiving TPA four hours after the second injection of endotoxin and was absent in animals receiving TPA five hours after the second dose of endotoxin. Glomerular fibrinolytic activity was reduced following development of the generalized Shwartzman reaction but was normal in animals that received TPA five hours after the second injection of endotoxin. TPA did not produce a systemic fibrinolytic state and did not prevent the decline in hematologic and coagulation factors typical of the Shwartzman reaction, despite the elimination of glomerular fibrin. These results suggest that TPA effectively removes glomerular thrombi in the generalized Shwartzman reaction and infers that TPA may be of value in the treatment of human diseases with similar pathology, such as the hemolytic uremic syndrome.
为研究组织型纤溶酶原激活剂（TPA）治疗对全身性施瓦茨曼反应中肾小球纤维蛋白沉积的影响，在第二次注射内毒素后立即、或三、四、或五小时给家兔静脉注射TPA。在第二次注射内毒素六小时后处死动物。在第二次注射内毒素四小时后接受TPA的动物中，肾小球纤维蛋白沉积减少，而在第二次注射内毒素五小时后接受TPA的动物中则无纤维蛋白沉积。全身性施瓦茨曼反应发生后，肾小球纤溶活性降低，但在第二次注射内毒素五小时后接受TPA的动物中，肾小球纤溶活性正常。尽管消除了肾小球纤维蛋白，但TPA并未产生全身性纤溶状态，也未阻止施瓦茨曼反应典型的血液学和凝血因子下降。这些结果表明，TPA可有效清除全身性施瓦茨曼反应中的肾小球血栓，并推测TPA可能对治疗具有类似病理的人类疾病（如溶血性尿毒症综合征）有价值。
