@article{oai:dmu.repo.nii.ac.jp:00000141,
 author = {渡辺, 淳一郎 and Watanabe, Junichiro},
 issue = {2},
 journal = {Dokkyo journal of medical sciences},
 month = {Jul},
 note = {急性心筋梗塞(AMI)の治療法として遺伝子変異型組織プラスミノゲンアクチベーター(mutant t-PA)であるモンテプラーゼ27,500 IU/kgの単回静脈先行投与と経皮的冠動脈形成術(PCI)の併用療法の妥当性を血漿プラスミノゲンアクチベーターインヒビター-1(PAI-1)動態から検討した。AMI患者126例を併用療法群(C群)58例とPCI単独施行群(P群)68例とに無作為に割付けし,血漿PAI-1抗原量をLPIA法で経時的に測定した。C群では初回冠動脈造影時TIMI II-IIIが得られた症例はTIMI 0-Iだった症例に比べ,搬入時PAI-1抗原量が有意に低値であった(P<0.05)。PAI-1抗原量は両群とも搬入時に正常基準値より高値であり,PCI後さらに上昇を認め24時問後までにピーク(C群:147.6±16.2%,P群:195.6±28.5%)を示した。しかし,その経時変化は両群間で有意差はなかった。ステント非留置症例では,48時間後のPAI-1抗原量はP群ではC群に比べ有意に(P<0.05)高値であった。以上の結果より,AMI発症早期に通常量のmutant t-PAであるモンテプラーゼの単回静脈投与は血漿PAI-1動態に影響を与えず,また本剤の先行投与はPCIとの併用療法でPAI-1動態に影響しないことが明らかとなった。, We investigated the clinical usefulness of combination therapy of single bolus injection of intravenous mutant t-PA (Monteplase 27500 IU/kg weight) and PCI for treatment of AMI in the light of PAI-ikinetics. Consecutive l26patients were randomly assigned to PCI following pre-treatment with intravenous Monteplase (group C ; n = 58) or receive direct PCI (group P ; n 68). The method of plasma PM-1 anti-gen was the latex photometric immunoassay (LPLA). In group C, the PAI-1 antigen levels at admission were lower in patients with TIMI II-III flow than in those with TIMI 0-I by first coronary angiography (P < 0.05). In both groups, the PM-1 antigen levels at admission were higher than normal value and increased maximally until 24 hrs (Group C 147.6 ± 16.2%, Group P : 195.6 ± 28.5%). Serial change patterns in the PMI-1 level were similar in both groups. In patients without stenting, PAI-1 levels after 48 hours were significantly higher Group P than Group C (P < 0.05). These results suggested that Monteplase as a pretreatment of AMI before PCI did not influenced in light of PMI-1 kinetics., 原著, Original},
 pages = {173--179},
 title = {プラスミノゲンアクチベーターインヒビター-1(PAI-1)動態からみた急性心筋梗塞時の冠血管形成術におけるモンテプラーゼ先行投与の影響},
 volume = {30},
 year = {2003},
 yomi = {ワタナベ, ジュンイチロウ}
}