Beythien C, Terres W, Gutensohn K, Meinertz T
Medizinische Klinik und Poliklinik, Universitäts-Krankenhaus Eppendorf, Hamburg.
Z Kardiol. 1996 Sep;85(9):661-7.
Thrombus age as a determinant of lysis efficacy has rarely been investigated. We developed an in vitro model to study the lysis of collagen induced platelet-fibrin-thrombi of different ages. Histologically, the thrombi were similar to those found in coronary vessels of patients deceased from acute myocardial infarction or unstable angina. After 10 (TA10), 30(TA30) und 60 (TA60) min of thrombus aging thrombolysis over 30 min with urokinase alone or in combination with prostaglandin E1 was started. The efficacy of lysis with urokinase alone decreased with increasing thrombus age. After 30 min of lysis with urokinase alone weight of TA10-thrombi was reduced by 16.4 +/- 1.2 mg, of TA30-thrombi by 11.5 +/- 0.9 mg (p < 0.001 vs TA10-thrombi) and of TA60-thrombi by 7.8 +/- 1.1 mg (p < 0.001 vs TA30, p < 0.0001 vs TA10-thrombi). The addition of prostaglandin Ei augmented lysis of TA10-thrombi, after 30 min of lysis thrombus weight was reduced by 17.3 +/- 1.2 mg (p < 0.01 vs urokinase alone). Lysis of 30 and 60 min old thrombi was nearly unaffected. Thus, thrombus age is a strong predictor of lysis efficacy of in vitro collagen induced platelet-fibrin-thrombi.
血栓形成时间作为溶栓疗效的决定因素鲜有研究。我们建立了一个体外模型，以研究不同形成时间的胶原诱导血小板 - 纤维蛋白血栓的溶解情况。组织学上，这些血栓与急性心肌梗死或不稳定型心绞痛死亡患者冠状动脉中发现的血栓相似。在血栓形成10分钟（TA10）、30分钟（TA30）和60分钟（TA60）后，开始用尿激酶单独或联合前列腺素E1进行30分钟的溶栓。单独使用尿激酶时，溶栓效果随血栓形成时间延长而降低。单独用尿激酶溶栓30分钟后，TA10血栓重量减少16.4±1.2毫克，TA30血栓减少11.5±0.9毫克（与TA10血栓相比，p<0.001），TA60血栓减少7.8±1.1毫克（与TA30相比，p<0.001；与TA10血栓相比，p<0.0001）。添加前列腺素E1可增强TA10血栓的溶解，溶栓30分钟后血栓重量减少17.3±1.2毫克（与单独使用尿激酶相比，p<0.01）。30分钟和60分钟形成的血栓溶解几乎不受影响。因此，血栓形成时间是体外胶原诱导血小板 - 纤维蛋白血栓溶解疗效的有力预测指标。
