b. 消耗性凝固障害における線溶の意義

抄録

A present trend to counter the consumption coagulopathy seems to be, more or less, deviated under the influence of the “a priori” concept that the fibrinolysis in such case will be a protective response of the body. Fact is, however, the concept has been enough proved neither clinically nor experimentally. This investigation, approaching the problem using the experimental animals, were carried out with the co-workers of the author and the following results obtained suggest that the older concept is urged to be re-considered.
The injection of thrombin into the renal artery which forms transiently the renal thrombi resulted in the decrease of the tissue plasminogen activator of the organ and also the increase of the activator of the blood obtained from the renal vein. These results imply that local activation of the fibrinolysis, favoring the removal of the local thrombi, does not necessarily accompany with the activation of the systemic fibrinolysis of the body. Another series of the experiments were made in such experimental conditions of the systemic circulatory blood as i) hyper-coagulability, ii) hyper-fibrinolysis, iii) hypercoagulability plus hyper-fibrinolysis. The grade of accerelation of these functions was adequately controlled. The overwhole picture of those results indicats that the hyper-fibrinolysis in the systemic blood can be “hazard” even in the animals suffering from the troubles caused by the hyper-coagulability. Thus it isconcluded that the clinical significance of hyperfibrinolysis in the systemic blood shouldbe clearly considered when compared with the local hyperfibrinolysis which may be favorable to the body. The further additional studies on the behavior of FDP with various conditions support a therapeutic principle that the systemic hyper-fibrinolysis associated with the consumption coagulopathy is to be treated with some combination of anti-coagulants and antifibrinolytic agents.