肺栓塞的溶栓治疗最佳时间是多久 溶栓药物有哪些 孟泳 河南省中医院 скачать в хорошем качестве

肺栓塞的溶栓治疗最佳时间是多久 溶栓药物有哪些 孟泳 河南省中医院

肺栓塞的溶栓治疗最佳时间是多久 溶栓药物有哪些 孟泳 河南省中医院 溶栓的时间窗一般定位14天以内，但若近期内有新发肺栓塞征象可以适当延长，对有明确溶栓指征的病例，宜尽早开始溶栓，溶栓药是促进纤维蛋白溶解，而溶解血栓的药，体内纤维蛋白溶解过程，是一系列蛋白酶催化连锁反应。第一阶段为血浆或组织中，凝血剂的活化并转化为，纤溶酶原激活剂。第二阶段为纤溶酶原转化为纤溶酶，纤维蛋白或纤维蛋白原被分解，然后溶栓酶可直接或间接，作用于纤溶系统各个环节，纤溶系统由纤溶酶原，纤溶酶，激活酶原和抑制物组成，溶栓酶又包括促进蛋白溶解剂，或纤溶酶原的直接激活剂，比如除链激酶外的一些直接激活剂，肺栓塞常用的溶栓药物有尿激酶，链激酶和重组组织型纤酶原激活剂，也叫rt-PA，这个是目前比较临床上常用的，重组组织型纤酶原激活剂，链激酶、尿激酶或者是阿替普酶，改善对凝块的穿透性，增加开通率，溶栓活力提高3～5倍。 How long is the best time for thrombolytic therapy of pulmonary embolism The time window of thrombolysis is generally within 14 days, However, if there are new signs of pulmonary embolism in the near future, it can be appropriately prolonged, For patients with clear indications of thrombolysis, It is advisable to start thrombolysis as early as possible, Thrombolytic agents promote fibrinolysis, And thrombolytic drugs, The process of fibrinolysis in vivo, It is a series of protease catalyzed chain reaction. The first stage is in plasma or tissue, The clotting agent is activated and converted into, Plasminogen activator. The second stage is the conversion of plasminogen to plasmin, Fibrin or fibrinogen is broken down, Then thrombolytic enzyme can be directly or indirectly, It acts on all parts of the fibrinolysis system, The fibrinolytic system consists of plasminogen, Plasmin, Activating the composition of zymogen and inhibitor, Thrombolytic enzymes also include protein solubilizers, Or a direct activator of plasminogen, For example, some direct activators other than streptokinase, Urokinase is a common thrombolytic agent for pulmonary embolism, Streptokinase and recombinant tissue plasminogen activator, It's also called RT PA, This is commonly used in clinical practice, Recombinant tissue type plasminogen activator, Streptokinase, urokinase or ateplase, Improve the penetration of clots, Increase the opening rate, The thrombolytic activity was increased 3-5 times.