并非所有血栓都是相同的：代谢综合征患者组织型纤溶酶原激活物（tPA）溶栓不足的综述。
Not all clots are created equal: a review of deficient thrombolysis with tissue plasminogen activator (tPA) in patients with metabolic syndrome.
机构信息
a Department of Clinical and Translational Sciences , West Virginia University , Morgantown , WV , USA.
b Department of Pediatrics , West Virginia University , Morgantown , WV , USA.
出版信息
Int J Neurosci. 2019 Jun;129(6):612-618. doi: 10.1080/00207454.2018.1550400. Epub 2018 Dec 27.
Abstract
Metabolic syndrome is a cluster of cardiovascular risk factors associated with a prothrombotic, proinflammatory and hypofibrinolysis state. Although resistance to tissue plasminogen activator (tPA) in metabolic syndrome patients has been associated with a defective fibrinolytic system, the factors and mechanisms underlining such resistance is unclear. While there is a great debate on proposed mechanisms, fundamental questions regarding resistance to tPA in metabolic syndrome patients with ischemic stroke remain unanswered. This article reviews articles and documents published between 2001 and 2017, and provides an overview of metabolic syndrome, factors associated with tPA resistance in metabolic syndrome, conflicting evidence of insufficient dosing of tPA in overweight/obese patients and future directions for research.
摘要
代谢综合征是一组心血管危险因素，与血栓形成前状态、炎症前状态和纤溶活性下降有关。尽管代谢综合征患者对组织型纤溶酶原激活物（tPA）的抵抗与纤溶系统缺陷有关，但这种抵抗的相关因素和机制尚不清楚。虽然对于提出的机制存在很大争议，但代谢综合征伴缺血性脑卒中患者对 tPA 抵抗的基本问题仍未得到解答。本文回顾了 2001 年至 2017 年间发表的文章和文献，概述了代谢综合征、与代谢综合征患者 tPA 抵抗相关的因素、超重/肥胖患者 tPA 剂量不足的矛盾证据以及未来的研究方向。
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2
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Circulation. 2017 Mar 7;135(10):e146-e603. doi: 10.1161/CIR.0000000000000485. Epub 2017 Jan 25.
3
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Am Med Stud Res J. 2014 Spring;1(1):29-38. doi: 10.15422/amsrj.2014.05.004.
4
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J Stroke Cerebrovasc Dis. 2015 Nov;24(11):2605-12. doi: 10.1016/j.jstrokecerebrovasdis.2015.07.015. Epub 2015 Sep 9.
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