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[低分子量肝素片段。各种参数的比较临床前研究]

[Low molecular weight heparin fractions. Comparative preclinical study of various parameters].

作者信息

Fareed J

机构信息

Loyola University Medical Center, Maywood, Illinois 60153.

出版信息

J Mal Vasc. 1987;12 Suppl B:59-63.

PMID:2834492
Abstract

Preliminary results of the use of heparin fractions of low molecular weight showed improved bioavailability, sustained pharmacological actions and less bleeding than with non-fractionated heparin. Although prepared by different chemical and enzymatic processes, low molecular weight heparin fractions (LMWHF) possess remarkably similar chemical properties but differ in their pharmacological activity. Significant variations have been noted in tests for anti-Xa activity using reagents of USP or European standards. A study was carried out with eight heparin fractions of low molecular weight: CY 216 and CY 222 (Choay, France), Kabi 2165 (Sweden), PK 10169 (Pharmuka, France), RD 11885 (Wyeth, USA), OP 2123 (Opocrin, Italy), ORG 10172 (Organon, low countries) and heparinase depolymerization products. Numerous biochemical and pharmacological tests were carried out. In protease generation tests these agents can exert antiprotease activity when anti-Xa and anti-IIa functional activities are totally absent: it can therefore be suggested that compounds that lack affinity for anti-III contribute to the biological activities of these agents. The LMWHF possess different profiles of platelet factor, protamine and polybrene neutralization. These agents produce platelet activation to various degrees and can produce heparins able to induce thrombocytopenia. Since heparin was chosen as reference products for LMWHF, numerous dosage problems were encountered. These agents also exhibit wide variations in hemorrhagic index in animal studies. Taking previous studies into account, these products could be improved to show a greater efficacy and safety level in clinical practice.

摘要

低分子量肝素片段的初步使用结果表明,与未分级肝素相比,其生物利用度提高,药理作用持续,出血更少。尽管低分子量肝素片段(LMWHF)是通过不同的化学和酶促过程制备的,但其化学性质非常相似,但其药理活性有所不同。在使用美国药典或欧洲标准试剂进行的抗Xa活性测试中,已注意到显著差异。对八种低分子量肝素片段进行了一项研究:CY 216和CY 222(法国Choay公司)、Kabi 2165(瑞典)、PK 10169(法国Pharmuka公司)、RD 11885(美国惠氏公司)、OP 2123(意大利Opocrin公司)、ORG 10172(荷兰欧加农公司)以及肝素酶解聚产物。进行了大量的生化和药理测试。在蛋白酶生成测试中,当抗Xa和抗IIa功能活性完全不存在时,这些药物可发挥抗蛋白酶活性:因此可以认为,对抗III缺乏亲和力的化合物有助于这些药物的生物活性。LMWHF具有不同的血小板因子、鱼精蛋白和鱼精蛋白中和特性。这些药物会不同程度地引起血小板活化,并可产生能够诱导血小板减少的肝素。由于选择肝素作为LMWHF的参考产品,因此遇到了许多剂量问题。在动物研究中,这些药物的出血指数也存在很大差异。考虑到先前的研究,这些产品可以改进,以在临床实践中显示出更高的疗效和安全性。

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