Theiss W
I. Medizinische Klinik und Poliklinik, Technischen Universität München, Klinikum Rechts der Isar.
Klin Wochenschr. 1988;66 Suppl 12:55-8.
Even sophisticated assays of blood coagulation and of fibrinolysis cannot predict the clinical success of thrombolytic therapy, nor can they prevent bleeding complications. Nevertheless, some laboratory monitoring is indicated before thrombolytic therapy to rule out contraindications, and it should also be performed during thrombolytic therapy as a guideline for substitution therapy in case of bleeding and for control of concommitant or subsequent anticoagulant therapy. An initial assessment should comprise the assay of fibrinogen, prothrombin time, partial thromboplastin time, and a platelet count. One to two hours after initiation of thrombolytic therapy and at its end (as well as at 12-hourly intervals in between in prolonged courses of thrombolytic therapy), a fibrinogen assay and a test that is sensitive to fibrin(ogen) degradation products (e.g. thrombin time, reptilase time, prothrombin time) should be performed.
即使是复杂的血液凝固和纤维蛋白溶解检测，也无法预测溶栓治疗的临床成功率，也不能预防出血并发症。然而，在溶栓治疗前仍需进行一些实验室监测以排除禁忌症，并且在溶栓治疗期间也应进行监测，作为出血时替代治疗以及控制同时或后续抗凝治疗的指导。初始评估应包括纤维蛋白原测定、凝血酶原时间、部分凝血活酶时间和血小板计数。在溶栓治疗开始后1至2小时以及治疗结束时（以及在延长的溶栓治疗过程中间隔12小时），应进行纤维蛋白原测定以及对纤维蛋白（原）降解产物敏感的检测（例如凝血酶时间、蛇毒凝血酶时间、凝血酶原时间）。
