Jilani Talha N., Siddiqui Abdul H.
HCA Healthcare Sunrise Health Graduate Medical Education Program
Northwell Health SIUH
Tissue plasminogen activator (tPA) is classified as a serine protease (an enzyme that cleaves peptide bonds in proteins). It is thus 1 of the essential components of blood clot dissolution. Its primary function includes catalyzing the conversion of plasminogen to plasmin, the primary enzyme involved in dissolving blood clots. Recombinant biotechnology has enabled the manufacture of tPA in laboratories, and these synthetic products are known as recombinant tissue plasminogen activators (rt-PA). These drugs have undergone various modifications to amplify their pharmacokinetics and pharmacodynamics, particularly by prolonging their short half-life in circulation and increasing their fibrin specificity to prevent an unwanted fibrinolytic state. Examples of these drugs include alteplase, reteplase, and tenecteplase. Indications for the use of tPA include the following:
组织型纤溶酶原激活剂（tPA）被归类为丝氨酸蛋白酶（能切割蛋白质中肽键的酶）。因此，它是溶解血凝块的重要成分之一。其主要功能包括催化纤溶酶原转化为纤溶酶，纤溶酶是参与溶解血凝块的主要酶。这类药物的例子包括阿替普酶、瑞替普酶和替奈普酶。tPA的使用指征包括症状发作后3小时内（某些符合条件的患者为4.5小时）到治疗机构就诊的患者发生的缺血性中风（最常见）、如果在经皮腔内冠状动脉成形术之前会有超过1至2小时的延迟则用于心肌梗死、大面积肺栓塞导致因心脏高压引起严重不稳定的肺栓塞以及溶栓（如深静脉血栓形成）。本活动概述了tPA药物的指征、作用机制、给药方法、重大不良反应、禁忌症、毒性以及监测，以便医疗服务提供者在作为跨专业团队的一部分有指征时指导患者治疗。
