Markwardt F, Glusa E
Z Gesamte Inn Med. 1978 Sep 1;33(17):628-32.
Thrombotic processes play a role not only as a sequel of arteriosclerosis, but also for its pathogenesis. Under this aspect a pharmacological regulation of the course of the reaction of thrombpcytes, the blood coagulation and the fibrinolysis gets significance. The prevention of the formation of fibrin by well-known anticoagulants, such as coumarines and heparin, seems little suited for a prophylaxis of arteriosclerosis. By a pharmacological regulation of the reaction of the blood platelets which are decisive for the initial phase of the formation of thrombi new possibilities for an intervention into the pathomechanisms of arteriosclerosis are the result. Her also realizations concerning the prostaglandin metabolism of the blood platelets and of the wall of vessels can be evaluated. The activation of fibrinolysis by means of the hitherto introduced fibrinolytics, such as streptokinase and urokinase, is used above all for the treatment of acute thrombi. In the sense of a prevention of arteriosclerosis the activation of the endogenic fibrinolysis with the help of indirect fibrinolytics, which effect a liberation of the activators of fibrinolysis localised in the wall of the vessels, is a hopful way.
血栓形成过程不仅是动脉硬化的后果，而且在其发病机制中也起作用。从这方面来看，对血小板反应过程、血液凝固和纤维蛋白溶解进行药理学调节具有重要意义。使用众所周知的抗凝剂如香豆素和肝素预防纤维蛋白形成，似乎不太适合预防动脉硬化。通过对在血栓形成初始阶段起决定性作用的血小板反应进行药理学调节，产生了干预动脉硬化发病机制的新可能性。在此还可以评估关于血小板和血管壁前列腺素代谢的认识。借助迄今引入的纤维蛋白溶解剂如链激酶和尿激酶激活纤维蛋白溶解，主要用于治疗急性血栓。从预防动脉硬化的意义上讲，借助间接纤维蛋白溶解剂激活内源性纤维蛋白溶解是一种有希望的方法，这些间接纤维蛋白溶解剂可促使血管壁中定位的纤维蛋白溶解激活剂释放。
