Pharmacologic and clinical characteristics of thrombolytic agents.
Pharmacologic and clinical characteristics of thrombolytic agents.
复制标题
溶栓剂的药理学和临床特征。
DOI：
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发表时间：
2002
影响因子：
2.7
通讯作者：
M. Jaff
中科院分区：
文献类型：
--
作者：
S. Deitcher;M. Jaff
动脉和静脉血栓栓塞事件，包括心肌梗死、缺血性中风、外周动脉血栓形成、深静脉血栓形成和肺栓塞，是常见的潜在威胁生命、器官和肢体的血管疾病。在这些情况下，建议在内源性纤溶系统逐渐清除血栓闭塞之前进行抗凝治疗，以防止进一步的血栓形成。对纤溶系统在血栓溶解中的重要性的认识导致了药理纤溶(溶栓)药物的发展，以促进血管快速恢复通畅。几种具有不同药代动力学和药效学性质的纤溶酶原激活剂(PA)已被开发出来用于治疗血栓性疾病。较新的PA已被开发为“纤维蛋白特异性”的团注给药药物，主要用于治疗急性冠脉综合征。对于相对较大的外周血管血栓，持续输注这些纤维蛋白特异性PA已变得流行起来。以新型组织型纤溶酶原激活剂为基础的PA缺乏输注可能会导致出血风险增加，包括颅内出血。目前可用的数据不能提供令人信服的证据表明，当使用新的PA治疗外周血管血栓时，比起成熟的药物，如尿激酶剂，提供了显著更好的有效性和安全性。
Arterial and venous thromboembolic events, including myocardial infarction, ischemic stroke, peripheral arterial thrombosis, deep venous thrombosis, and pulmonary embolism are common potentially life-, organ-, and limb-threatening vascular diseases. Anticoagulant therapy is recommended in these settings to prevent further thrombosis pending gradual clearance of the thrombotic occlusion by the endogenous fibrinolytic system. Recognition of the importance of the fibrinolytic system in thrombus resolution has resulted in the development of pharmacologic fibrinolytic (thrombolytic) agents to facilitate rapid restoration of vascular patency. Several plasminogen activator (PA) thrombolytic agents with different pharmacokinetic and pharmacodynamic properties have been developed to treat thrombotic disease. Newer PAs have been developed as "fibrin-specific", bolus-administration drugs to primarily treat acute coronary syndromes. Continuous infusions of these fibrin-specific PAs have become popular for the lysis relatively larger peripheral vascular thromboses. Loss infusion of newer tissue-type plasminogen activator-based PAs may result in an increased risk of bleeding, including intracranial hemorrhage. Currently available data fail to provide compelling evidence that newer PAs offer significantly greater efficacy and safety than well-established agents like urokinase when used to treat peripheral vascular thrombosis.