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单链尿激酶型纤溶酶原激活剂和组织型纤溶酶原激活剂在犬动脉血栓形成模型中的推注剂量反应特征。

Bolus dose response characteristics of single chain urokinase plasminogen activator and tissue plasminogen activator in a dog model of arterial thrombosis.

作者信息

Badylak S F, Voytik S, Klabunde R E, Henkin J, Leski M

机构信息

Hillenbrand Biomedical Engineering Center, Abbott Park, IL 60064.

出版信息

Thromb Res. 1988 Nov 15;52(4):295-312. doi: 10.1016/0049-3848(88)90071-0.

Abstract

Tissue plasminogen activator (t-PA) and single chain urokinase-plasminogen activator (scu-PA) are relatively "fibrin-specific" thrombolytic drugs with short plasma half lives of 6-8 minutes. Most treatment regimens with these agents utilize a bolus injection followed by continuous drug infusion, usually combined with anticoagulant therapy. The purpose of this study was to establish the dose-response characteristics for scu-PA and t-PA, when given as a single intravenous bolus injection, in a dog model of arterial thrombosis. Eight groups of 6 dogs each were given one of the following doses of scu-PA (mg/kg): 0.20, 0.50, 1.00, 2.00; or t-PA: 0.05, 0.10, 0.20; or an equivalent amount of saline (control group). All doses were given as a single bolus injection 60 minutes after formation of a totally occlusive femoral artery thrombus. Thrombolysis was measured by monitoring the continuous decrement of 125I activity from a radiolabelled thrombus. Ninety minutes after drug injection, all scu-PA treated dogs showed greater thrombolysis (30%, 45%, 56%, and 67%, respectively) than the control group (15%, p less than 0.01). The 0.10 and 0.20 mg/kg t-PA treated dogs showed greater thrombolysis (35% and 49%, respectively) than the control group (15%, p less than 0.01). Both scu-PA and t-PA caused a partial and dose-dependent decrease in alpha 2-antiplasmin activity but scu-PA caused a greater depletion (72% vs. 18%, respectively, p less than 0.05) at 60 minutes after the highest dose of drug administration. Both drugs showed a longer than expected thrombolytic effect based upon the known half lives. Neither drug caused significant changes in the prothrombin time, activated partial thromboplastin time, thrombin time, hematocrit, platelet count, or fibrin degradation product concentration. Single bolus injections of scu-PA and t-PA produce safe and effective thrombolysis in this dog model of arterial thrombosis.

摘要

组织型纤溶酶原激活剂(t-PA)和单链尿激酶型纤溶酶原激活剂(scu-PA)是相对“纤维蛋白特异性”的溶栓药物,血浆半衰期较短,为6 - 8分钟。使用这些药物的大多数治疗方案采用静脉推注,随后持续输注药物,通常联合抗凝治疗。本研究的目的是在动脉血栓形成的犬模型中,确定单次静脉推注scu-PA和t-PA时的剂量反应特征。将八组,每组6只犬,分别给予以下剂量的scu-PA(mg/kg):0.20、0.50、1.00、2.00;或t-PA:0.05、0.10、0.20;或等量的生理盐水(对照组)。在完全闭塞的股动脉血栓形成60分钟后,所有剂量均作为单次推注给药。通过监测放射性标记血栓中125I活性的持续下降来测量溶栓情况。药物注射90分钟后,所有接受scu-PA治疗的犬的溶栓程度均高于对照组(分别为30%、45%、56%和67%,而对照组为15%,p < 0.01)。接受0.10和0.20 mg/kg t-PA治疗的犬的溶栓程度也高于对照组(分别为35%和49%,而对照组为15%,p < 0.01)。scu-PA和t-PA均导致α2 - 抗纤溶酶活性呈部分性和剂量依赖性降低,但在给予最高剂量药物60分钟后,scu-PA导致的活性消耗更大(分别为72%对18%,p < 0.05)。基于已知的半衰期,两种药物均显示出比预期更长的溶栓效果。两种药物均未引起凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、血细胞比容、血小板计数或纤维蛋白降解产物浓度的显著变化。在该动脉血栓形成的犬模型中,单次推注scu-PA和t-PA可产生安全有效的溶栓效果。

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