摘要
由血栓引起的血栓性疾病是一种常见的心脑血管疾病。溶栓剂是预防与治疗心脑血管疾病的主要抗血栓药物。本文总结性地概述了目前国内外各种新型溶栓剂的溶栓机理、临床应用效果及其副作用等。其中,第三代溶栓剂组织型纤溶酶原激活剂变异体、导向溶栓剂、嵌合体溶栓剂,以及部分天然溶栓剂包括蝙蝠唾液纤溶酶原激活剂、蛇毒纤溶酶原激活剂、水蛭素及其变异体等均通过将纤溶酶原激活为纤溶酶溶解血栓。临床实验结果表明它们在延长体内半寿期、增强对血纤维蛋白选择性和溶栓效率等方面有较大的改进,但溶栓治疗后的冠状动脉再栓塞,颅内出血等问题仍是目前未解决的难题;而纳豆激酶及豆豉纤溶酶由于溶栓原理的不同,引起内出血的几率较低。溶栓剂未来的发展方向为如何综合不同药物的优点,使其更加安全与廉价。
Arterial thrombosis is the underlying cause of a wide variety of cerebro-cardiovascular diseases. All the currently used thrombolytic agents are very efficient in restoring the blood flow. The recent development in thrombolytic drugs, including the third-generation thromblytic agents and natural thromblytic agents, is presented in this article. The thrombolytic mechanism, adverse reaction and the clinical application of these drugs are especially introduced. Most of the third-generation thromblytic agents are variants of tissue type plasmino-gen activator, such as reteplase, monteplase, tenecteplase and lanoteplase. All of them and some natural thromblytic agents including staphylokinase, lumbrokinase and hirudin are plasminogen activators, which can convert plasminogen into plasmin and thus degrade fibrin. They have showed considerable potential with higher potency, specific thrombolytic activity, fibrin selectivity and longer half-life time, but all these agents suffer from a number of inadequacies including resistance to reperfusion, occurrence of coronary reocelusion and bleeding complications. The thrombolytic mechanism of nattokinase and fibrinolytic enzyme in douchi are specific, and they won＇ t cause bleeding complications. The further develoment of thrombolytic agents is how they can get safer and eheaper.
出处
《重庆师范大学学报（自然科学版）》
CAS
2010年第1期69-73,98,共6页
Journal of Chongqing Normal University:Natural Science
基金
重庆市自然科学基金重点项目(No.CSTC2008BA5030)
关键词
溶栓剂
现状
展望
血栓
纳豆激酶
thrombolytic drug
recent development
perspective
cerebro-cardiovascular
nattokinase
