CLINICAL PHARMACOLOGY OF VARIOUS TYPES OF FIBRINOLYTIC ENZYME PREPARATIONS
CLINICAL PHARMACOLOGY OF VARIOUS TYPES OF FIBRINOLYTIC ENZYME PREPARATIONS
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DOI：
10.1016/0002-9149(60)90340-4
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发表时间：
1960-01-01
影响因子：
2.8
通讯作者：
FISHMAN, JB
中科院分区：
文献类型：
--
作者：
AMBRUS, JL;AMBRUS, CM;FISHMAN, JB
196例患者接受了各种类型的纤溶酶制剂治疗。在538例静脉和/或动脉输液中，12例发生出血，2例发生肺栓塞。热原副作用在早期制剂中常见，但在385次使用更新，更纯化制剂的治疗中仅出现4次。输注4至8小时后，凝血系统因子的降低幅度从未达到具有临床意义的程度。快速静脉注射导致更明显的变化。最常受影响的因素是凝血酶原、因子V、因子VII和纤维蛋白原。在初始疗程后三周，再次使用链激酶或链激酶激活的纤溶酶治疗，导致三例病例中的两例出现过敏样反应。尿激酶激活纤溶酶再治疗没有引起副作用，并没有导致12例治疗活性下降。在血栓性静脉炎或大静脉血栓形成的情况下（主要是老年患者肿瘤性疾病的并发症），在62例接受链激酶、尿激酶或氯仿激活的纤溶酶、链激酶或尿激酶单独或与抗凝剂联合治疗的患者中，28例（45%）恢复正常，20例（32%）在5天内好转，6例（10%）无好转，1例死于肺栓塞。所有使用的制剂似乎都具有治疗活性。本研究的目的和方法排除了在随机双盲基础上使用匹配的对照组患者。然而，治疗组的患者与纤维蛋白溶解酶治疗的结果上级未治疗组或抗凝治疗组。
196 patients were treated with various types of fibrinolytic enzyme preparations. Of 538 intravenous and/or intra-ar-terial infusions, hemorrhage occurred in 12 cases, and pulmonary embolism in 2. Pyrogenic side effects were seen commonly with earlier preparations but only four times in 385 treatments with newer, more purified preparations. With 4 to 8 -hour infusions, decrease of factors of the blood clotting system was never of sufficient magnitude to be of clinical significance. Rapid intravenous injection resulted in more pronounced changes. Factors most often affected were prothrombin, factor V, factor VII and fibrinogen. Retreatment with streptokinase or streptokinase-activated plasmin three weeks after an initial course of therapy resulted in anaphylactoid reactions in two of three cases. Retreatment with urokinase-activated plasmin caused no side effects and did not result in decreased therapeutic activity in 12 cases. In cases of thrombophlebitis or thrombosis of the large veins (chiefly complications of neoplastic diseases in elderly patients) of less than 5 days'' standing when treatment was initiated, of 62 patients treated with streptokinase, urokinase- or chloroform-activated plasmin, streptokinase or urokinase, alone or in combination with anticoagulants, 28 (45%) returned to normal and 20 (32%) improved in less than 5 days, 6 (10%) did not improve and 1 died of pulmonary embolism. All preparations used appeared to be therapeutically active. The objectives and methods of this study precluded the use of a matched control group of patients on a randomized double-blind basis. Nevertheless, therapeutic results in the groups of patients treated with fibrinolysin were superior to those in the untreated group or groups treated with anticoagulants.