Can we use thrombolytic drugs in advance to dissolve the potential thrombus and clean the blood vessels?

When doing the science popularization of atherosclerosis, an old friend asked huazi a question. With such advanced science and technology, why can’t we use thrombolytic drugs in advance, for example, once in the first half of the year and once in the second half of the year, so as to dissolve all the potential thrombi in the body and clean the blood vessels, so as to prevent thrombosis?

huazi replied that in fact, the current medical technology is not so developed, and there is no medicine to “clean” the blood vessels in the body. For thrombotic diseases, thrombolysis can only be carried out at the time of occurrence. It can not achieve the effect of cleaning blood vessels by using in advance.

this old friend put forward the concept of “potential thrombosis”. Maybe many people share his idea that before the formation of thrombus, it is like the scale accumulated in the water pipe, accumulating more and more, and finally blocking the pipe. So before the accumulation of scale, try to dissolve it, it will not be blocked. But in fact, this view is wrong, the human thrombus is not the scale in the water pipe.

human thrombosis is mainly due to atherosclerosis. The pathological process of atherosclerosis is firstly the injury of intima, and then cholesterol enters the intima from the injury. Cholesterol entering the intima will cause inflammatory stimulation, and the human body will order macrophages to phagocytize these cholesterol.

if you swallow too much cholesterol, macrophages can’t break it down. So these macrophages loaded with cholesterol can be transformed into foam cells and deposited in the intima of the arteries. The accumulation of more foam cells eventually leads to hardening plaque. These foam cells filled with cholesterol are yellow granules, which look like millet congee, so they are called atherosclerosis.

these atherosclerotic plaques are the basis of thrombosis, which is called “potential thrombosis”. But they grow in the intima of the artery. If you want to “clean” them out, you have to destroy the intima first. With the current medical technology, it is impossible to remove the atherosclerotic plaque without damaging the intima.

if we don’t control the factors that cause artery intima damage, atherosclerotic plaque will continue to grow, resulting in vascular stenosis, and eventually lead to total occlusion. But the progress of plaque is very slow. It usually takes decades from the discovery of plaque to the complete occlusion of blood vessels. At this stage, as long as timely and effective treatment, we can stop the progression of plaque.

However, some plaques will not grow up honestly and slowly. They may be very unstable. Under the inducement of violent fluctuation of blood pressure and arterial spasm, the plaques may break. The broken surface of plaque will stimulate platelet aggregation in the blood, and then platelets will activate fibrin coagulation in the blood, forming a “net” to “tie” the blood cells together and form thrombus. It can cause artery blockage, which leads to myocardial infarction, cerebral infarction and other thrombotic diseases.

thrombolytic drugs mainly refer to urokinase, streptokinase, fibrinolytic enzyme, alteplase and other drugs, which act on fibrin and can dissolve fibrin in coagulated state again, so that thrombus can be ablated and blood vessels can be restored. But thrombolytic drugs can only be used in the early stage of thrombosis, when the time is long, thrombosis will occur “organization”, that is to say, the thrombosis has become blood vessels grow together, thrombolytic drugs have no effect.

that is to say, thrombolytic drugs only act on the newly coagulated fibrin. It is meaningless to use thrombolytic drugs before thrombosis, and it is easy to cause side effects of bleeding, so it can not be used to prevent thrombosis. If the thrombus clots too long, it doesn’t work. Therefore, when cerebral infarction and myocardial infarction occur, the “golden time” of using thrombolytic drugs for rescue is very short, usually only about 3 hours, and the longest can not exceed 6 hours.

first, we need to intervene in the factors causing arterial intimal injury, such as smoking, hypertension, hyperlipidemia and diabetes. So to quit smoking, blood pressure, blood sugar, blood lipid control. If diet and exercise can not make these indicators reach normal, then it is necessary to take medicine under the guidance of doctors as soon as possible.

chronic disease itself is not terrible. What is terrible is the concurrent diseases it brings. Although the current medical technology can not completely cure these chronic diseases, rational drug use can control the progress of chronic diseases and delay or avoid the occurrence of complications. It doesn’t affect the quality of life or life expectancy.

second, if the atherosclerotic plaque is unstable, statins can be used under the guidance of doctors to “reinforce” the plaque and make it difficult to break. At the same time, anti platelet drugs, such as aspirin, clopidogrel and ticagrelor, can be used to prevent platelet aggregation when plaque breaks. So as to avoid activating fibrin and prevent thrombosis.

at the same time of rational drug use, low salt, low-fat, low sugar diet, less meat, more vegetables and fruits, and moderate exercise. Although it can not completely eliminate the plaque, it can reduce the plaque and reverse the plaque.

to sum up, atherosclerotic plaques grow in the intima of arteries. Before thrombosis occurs, thrombolytic drugs cannot be used to “clean” the blood vessels. With the current level of science and technology, the best way to protect blood vessels and prevent thrombosis is to improve the healthy lifestyle, avoid the risk factors of damaging artery intima, and use drugs under the guidance of doctors to prevent related risk factors. I’m huazi, pharmacist. Welcome to pay attention to me and share more health knowledge. 21 days after delivery, the pregnant woman had a new baby, but the doctor did not find it was “twins”