<総説>線維素溶解現象の臨床的意義 : 血液凝固と線溶の動的平衡
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Mammalian blood contains two opposite enzymatic systems. One is the coagulation system capable of clot formation of blood and the other is the fibrinolytic system capable of dissolving blood clots. Thrombus formation is brought about by the imbalance of the dynamic equivalent mechanism between blood coagulation and fibrinolysis. Fibrinolysis is known as the mechanism for dissolving of fibrin formed. It was, however, clarified by Nossel (1981) that the relative rate at which thrombin split the peptide of fibrin I, which was the fibrin of the first stage of the forming fibrin, and the relative rate at which plasmin split the peptide of fibrin I, could determine the occurrence of thrombosis. From this study it was proposed by Rosenberg & Rosenberg (1984) that the fibrinolytic system acts not only as the mechanism for dissolving of the fibrin formed, but also as one of the mechanisms for natural anticoagulation. The conversion of plasminogen to plasmin, which plays the main role in fibrinolysis, is due to the plasminogen activators. The plasminogen activators are classified as follows : One is the intrinsic plasminogen activators which are recognized in the blood obtained at rest. And the other is the extrinsic plasminogen activator mainly released from the endothelial cells of the vascular wall into the circulating blood by some mediators e. g. shock, stress, exercise, venous occlusion etc ……. It is speculated that the intrinsic plasminogen activator plays an important role as the natural anticoagulant mechanism of fibrinolysis, and that extrinsic plasminogen activator mainly acts as the mechanism capable of dissolving fibrin formed. In this paper are described outline of the new findings obtained regarding fibrinolysis, especially about the promoting factors and their function, and the clinical significance of fibrinolysis.
- 北海道医療大学の論文
- 1984-12-31
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