Vrolix M, Van de Werf F
University of Leuven, Belgium.
Curr Opin Cardiol. 1992 Aug;7(4):595-601. doi: 10.1097/00001573-199208000-00009.
Over the past year, the results of large-scale trials have better defined the risk to benefit ratios of thrombolytic therapy in specific subgroups of patients. However, important issues such as prevention of early reocclusion, prehospital administration of thrombolytics, adjunctive treatment with beta-blockers or angiotensin-converting enzyme inhibitors and early noninvasive detection of reperfusion remained unsolved. Encouraging data have been reported in selected patients for the more aggressive approach of direct angioplasty without thrombolysis. However, the results from large, randomized trials, comparing direct angioplasty with conventional thrombolysis, are still lacking. A postthrombolysis strategy of watchful waiting has been corroborated by new findings.
在过去一年中，大规模试验的结果已更明确地界定了溶栓治疗在特定患者亚组中的风险效益比。然而，诸如预防早期再闭塞、院前给予溶栓剂、β受体阻滞剂或血管紧张素转换酶抑制剂的辅助治疗以及再灌注的早期无创检测等重要问题仍未得到解决。在部分患者中，对于不进行溶栓的更积极的直接血管成形术方法已有令人鼓舞的数据报道。然而，比较直接血管成形术与传统溶栓治疗的大型随机试验结果仍未得出。新的研究结果证实了溶栓后观察等待的策略。
