関: fibrinolytic therapy

WordNet

(medicine) the act of caring for someone (as by medication or remedial training etc.); "the quarterback is undergoing treatment for a knee injury"; "he tried every treatment the doctors suggested"; "heat therapy gave the best relief"
a kind of pharmaceutical that can break up clots blocking the flow of blood to the heart muscle (同)thrombolytic_agent, clot buster

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(病気の)治療,療法 / =psychotherapy

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/09/15 22:58:37」(JST)

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Thrombolytic drugs are used in medicine to dissolve blood clots in a procedure termed thrombolysis. They limit the damage caused by the blockage or occlusion of a blood vessel.^[1]

Uses

Thrombolytic agents are used for the treatment of myocardial infarction (heart attack),^[2] thromboembolic strokes, deep vein thrombosis and pulmonary embolism to clear a blocked artery and avoid permanent damage to the perfused (see perfusion) tissue (e.g. myocardium, brain, leg) and death.^[3] They may also be used to clear blocked catheters that are used in long-term medical therapy.

Thrombolytic therapy in hemorrhagic strokes is contraindicated, as its use in that situation would prolong bleeding into the intracranial space and cause further damage.

Laboratory findings in various platelet and coagulation disorders (V - T)
Condition	Prothrombin time	Partial thromboplastin time	Bleeding time	Platelet count
Vitamin K deficiency or warfarin	Prolonged	Normal or mildly prolonged	Unaffected	Unaffected
Disseminated intravascular coagulation	Prolonged	Prolonged	Prolonged	Decreased
Von Willebrand disease	Unaffected	Prolonged or unaffected	Prolonged	Unaffected
Hemophilia	Unaffected	Prolonged	Unaffected	Unaffected
Aspirin	Unaffected	Unaffected	Prolonged	Unaffected
Thrombocytopenia	Unaffected	Unaffected	Prolonged	Decreased
Liver failure, early	Prolonged	Unaffected	Unaffected	Unaffected
Liver failure, end-stage	Prolonged	Prolonged	Prolonged	Decreased
Uremia	Unaffected	Unaffected	Prolonged	Unaffected
Congenital afibrinogenemia	Prolonged	Prolonged	Prolonged	Unaffected
Factor V deficiency	Prolonged	Prolonged	Unaffected	Unaffected
Factor X deficiency as seen in amyloid purpura	Prolonged	Prolonged	Unaffected	Unaffected
Glanzmann's thrombasthenia	Unaffected	Unaffected	Prolonged	Unaffected
Bernard-Soulier syndrome	Unaffected	Unaffected	Prolonged	Decreased or unaffected
Factor XII deficiency	Unaffected	Prolonged	Unaffected	Unaffected
C1INH deficiency	Unaffected	Shortened	Unaffected	Unaffected

Members

The thrombolytic drugs include:

tissue plasminogen activator t-PA:

alteplase (Activase)
reteplase (Retavase)
tenecteplase (TNKase)

anistreplase (Eminase)
streptokinase (Kabikinase, Streptase)
urokinase (Abbokinase)

These drugs are most effective if administered immediately after it has been determined they are clinically appropriate. The advantage of administration is highest within the first sixty minutes after a thrombotic event, but may extend up to six hours after the start of symptoms.

These drugs are often administered in combination with anticoagulant drugs such as intravenous heparin or low molecular weight heparin, for synergistic antithrombotic effects and secondary prevention.

Side-effects

Hemorrhagic stroke is a rare but serious complication of thrombolytic therapy. If a patient has had thrombolysis before, an allergy against the thrombolytic drug may have developed (especially after streptokinase). If the symptoms are mild, the infusion is stopped and the patient is commenced on an antihistamine before infusion is recommenced. Anaphylaxis generally requires immediate cessation of thrombolysis.

References

^ "Thrombolytic therapy".
^ Ellen C Keeley, Judith A Boura, Cindy L Grines (4 January 2003). "Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials". The Lancet 361: 13–20. doi:10.1016/S0140-6736(03)12113-7. PMID 12517460.
^ Selim M. Arcasoy, MD; John W. Kreit (June 1999). "Thrombolytic Therapy of Pulmonary Embolism: A Comprehensive Review of Current Evidence". Chest Journal 115: 1695–1707. doi:10.1378/chest.115.6.1695.

UpToDate Contents

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1. 急性肺塞栓症および下肢深部静脈血栓症における線溶（血栓溶解）療法 fibrinolytic thrombolytic therapy in acute pulmonary embolism and lower extremity deep vein thrombosis
2. ST上昇型心筋梗塞に対する線溶療法：治療開始 fibrinolytic therapy in acute st elevation myocardial infarction initiation of therapy
3. 急性虚血性脳卒中における経静脈的線維素溶解（血栓溶解）治療：治療的使用 intravenous fibrinolytic thrombolytic therapy in acute ischemic stroke therapeutic use
4. ST上昇型心筋梗塞における血栓溶解療法の特性および臨床試験 characteristics of fibrinolytic thrombolytic agents and clinical trials in acute st elevation myocardial infarction
5. 下肢の急性動脈閉塞（急性下肢虚血）の概要 overview of acute arterial occlusion of the extremities acute limb ischemia

English Journal

Predicting stroke evolution: comparison of susceptibility-weighted MR imaging with MR perfusion.

Kao HW, Tsai FY, Hasso AN.SourceDepartment of Radiological Sciences, University of California at Irvine Medical Center, 101 City Dr. South, Orange, Irvine, CA, 92868, USA.
European radiology.Eur Radiol.2012 Jul;22(7):1397-403. Epub 2012 Feb 10.
OBJECTIVES: To investigate the ability of susceptibility-weighted imaging (SWI) to predict stroke evolution in comparison with perfusion-weighted imaging (PWI).METHODS: In a retrospective analysis of 15 patients with non-lacunar ischaemic stroke studied no later than 24 h after symptom onset, we us
PMID 22322311

Novel multi-functional nitrones for treatment of ischemic stroke.

Sun Y, Zhang G, Zhang Z, Yu P, Zhong H, Du J, Wang Y.SourceInstitute of New Drug Research and Guangdong Province Key Laboratory of Pharmacodynamic Constituents of Traditional Chinese Medicine, Jinan University College of Pharmacy, Guangzhou 510632, China.
Bioorganic & medicinal chemistry.Bioorg Med Chem.2012 Jun 15;20(12):3939-45. Epub 2012 Apr 21.
Ischemic stroke resulting from obstruction of blood vessels is an enormous public health problem with urgent need for effective therapy. The co-administration of thrombolytic/antiplatelet agent and neuroprotective agent improves therapeutic efficacy and agent possessing both thrombolytic/antiplatele
PMID 22579617

Japanese Journal

症例報告経静脈的および経動脈的に血行再建術をおこなった心臓粘液腫による脳塞栓症の1例

神谷雄己,市川博雄,水間啓太 [他]
臨床神経学 = Clinical neurology 54(6), 502-506, 2014-06
NAID 40020121686

Purification and characterization of a novel fibrinolytic α chymotrypsin like serine metalloprotease from the edible mushroom, Lyophyllum shimeji(ENZYMOLOGY, PROTEIN ENGINEERING, AND ENZYME TECHNOLOGY)

Moon Sung-Min,Kim Jae-Sung,Kim Heung-Joong [他],Choi Mi Suk,Park Bo Ram,Kim Su-Gwan,Ahn Hoon,Chun Hong Sung,Shin Yong Kook,Kim Jong-Jin,Kim Do Kyung,Lee Sook-Young,Seo Young-Woo,Kim Yong Hwan,Kim Chun Sung
Journal of bioscience and bioengineering 117(5), 544-550, 2014-05
… shimeji, might be useful for thrombolytic therapy and preventing thrombotic disease. …
NAID 110009823128

保存的治療後の上腸間膜静脈血栓症に合併した遅発性小腸狭窄に対して内視鏡的拡張術が奏功した1例

方堂祐治,守護晴彦,米島學
日本消化器内視鏡学会雑誌 56(6), 1980-1985, 2014
症例は62歳，男性．B型慢性肝炎にて内服治療中に腹痛を自覚し，腹部CTにて上腸間膜静脈血栓症と診断した．保存的に抗凝固，血栓溶解療法を施行し血栓症は改善したが，発症75日後に小腸狭窄による腸閉塞をきたした．腹部CTにて空腸に限局する長さ2cm程度の狭窄を認めたため，小腸シングルバルーン内視鏡にて狭窄部を観察し，内視鏡的バルーン拡張術を施行した．その後は1年以上狭窄症状なく経過している．上腸間膜静脈 …
NAID 130004555338

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リンク元	「血栓溶解術」「血栓溶解療法」「fibrinolytic therapy」
拡張検索	「intravenous thrombolytic therapy」
関連記事	「therapy」「thrombolytic」「thrombolytics」