高濃度ｔｈｒｏｍｂｉｎの止血効果について

Abstract

Since high-concentrate thrombin preparations have excellent effectiveness for local hemostasis in patients with coagulopathies, the blood coagulation mechanism in the presence of high-concentrate thrombin, using purified thrombin, and plasminogen-free fibrinogen was investigated. The blood coagulation analyzer, Coag-Stat was utilized in the kinetic study of fibrin transformation. The first stage of fibrin precipitation speed was accelerated as the concentration increased and amounts of fibrin were gradually decreased in relation to the amount of sodium heparin given. The general result of this investigation was that anti-thrombin III and a large amount of heparin caused neutralization of dosages of 100 units/ml thrombin with neutralization increasing with heparin dosage. In the investigation of thrombin diffusion, high-concentrate thrombin was diffused on an agarose plate, containing plasminogen-free fibrinogen, and was seen to precipitate an increasing amount of fibrin.From the result of this study, the accelerative function of thrombin in blood coagulation was confirmed again. High-concentrate thrombin penetrated and diffused into the fibrin network during scores of hours. We presume that this function brings about continual hemostatic efficacy. In a practical clinical application of thrombin, it seems that plasma inhibitor and released heparinoid affect the preparation. From this experiment about 100 units/ml of thrombin was neutralized under AT-III and extra doses of heparin. Moreover, taking many kinds of plasma inhibitors into consideration, this approach showed that clinically more than 1000 units/ml thrombin was more effective.