Wikström K, Mattsson C, Pohl G
KabiPharmacia, Stockholm, Sweden.
Thromb Res. 1993 May 1;70(3):217-24. doi: 10.1016/0049-3848(93)90128-b.
The way in which three thrombolytic agents, tissue-type plasminogen activator (t-PA), streptokinase (SK) and a genetically engineered variant of t-PA composed of the second kringle and the protease domain (K2P), cause the dissolution of haemostatic plugs of differing ages was investigated in a novel rabbit model. Standardized incisions were made on the rabbit ear and the wounds were left to heal for 0.5 h or 24 h, before the thrombolytic agents were infused. In the absence of heparin, t-PA showed little discrimination between clots of different ages (36% and 28% lysis of the 0.5 h and 24 h wounds, respectively). In contrast, K2P and SK showed a pronounced fresh clot selectivity since they were significantly more effective in lysing fresh clots than old ones (68% and 4% lysis for K2P and 72% and 36% for SK, respectively). In the presence of heparin the potency of t-PA on fresh clots was considerably increased whilst the effect on old clots was not affected, a fresh clot selectivity for t-PA (64% lysis of fresh clots, 24% lysis of old clots) was thus effected. Heparin did not significantly affect the fresh clot selectivity of K2P or SK, although lysis of old clots was increased (from 4% to 36%) when it was given together with K2P. Furthermore, heparin did not affect the time to onset of bleeding nor was the bleeding time prolonged by its addition. The bleeding time observed for t-PA (20-25 min) was markedly shorter than that found for K2P or SK (40-50 min).(ABSTRACT TRUNCATED AT 250 WORDS)
在一种新型兔模型中,研究了三种溶栓剂,即组织型纤溶酶原激活剂(t-PA)、链激酶(SK)以及由第二个kringle结构域和蛋白酶结构域组成的t-PA基因工程变体(K2P),溶解不同年龄止血栓的方式。在兔耳上制作标准化切口,让伤口愈合0.5小时或24小时,然后注入溶栓剂。在没有肝素的情况下,t-PA对不同年龄的血栓几乎没有区分能力(分别使0.5小时和24小时伤口的血栓溶解36%和28%)。相比之下,K2P和SK表现出明显的新鲜血栓选择性,因为它们溶解新鲜血栓比陈旧血栓更有效(K2P分别为68%和4%溶解,SK分别为72%和36%溶解)。在有肝素的情况下,t-PA对新鲜血栓的效力显著增加,而对陈旧血栓的作用不受影响,因此实现了t-PA对新鲜血栓的选择性(新鲜血栓溶解64%,陈旧血栓溶解24%)。肝素对K2P或SK的新鲜血栓选择性没有显著影响,尽管与K2P一起使用时,陈旧血栓的溶解增加(从4%增加到36%)。此外,肝素不影响出血开始时间,添加肝素也不会延长出血时间。观察到t-PA的出血时间(20 - 25分钟)明显短于K2P或SK的出血时间(40 - 50分钟)。(摘要截短于250字)