Bode C, Runge M S, Smalling R W
Department of Cardiology, Medical Clinic III, University of Heidelberg, Heidelberg, Germany.
Eur Heart J. 1996 Sep;17 Suppl E:55-60. doi: 10.1093/eurheartj/17.suppl_e.55.
The ability of thrombolytic therapy to lower mortality in patients with acute myocardial infarction was first demonstrated in 1986 by the Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto Miocardico. In the ensuing 10 years, large efforts have been undertaken to develop more effective and safer thrombolytic agents. In addition, the value of adjunctive agents influencing thrombotic and thrombolytic processes was demonstrated, and newer agents are under active investigation. This review focuses on theoretical and practical aspects of optimizing thrombolytic therapy and on genetically engineered third generation plasminogen activators. Optimized thrombolytic therapy may make this form of therapy available to patients who are currently considered ineligible, and it will lead to earlier, more complete reperfusion of infarct-related coronary arteries. The benefits and risks of optimized thrombolytic regimens relative to those of mechanical reperfusion strategies will require constant reassessment while both forms of treatment develop.
1986年，意大利心肌梗死链激酶研究组首次证明了溶栓疗法降低急性心肌梗死患者死亡率的能力。在随后的10年里，人们付出了巨大努力来研发更有效、更安全的溶栓药物。此外，影响血栓形成和溶栓过程的辅助药物的价值也得到了证实，新型药物正在积极研究中。本综述重点关注优化溶栓治疗的理论和实践方面以及基因工程第三代纤溶酶原激活剂。优化后的溶栓治疗可能会使目前被认为不符合条件的患者也能接受这种治疗方式，并将导致梗死相关冠状动脉更早、更完全的再灌注。在两种治疗方式不断发展的过程中，相对于机械再灌注策略，优化溶栓方案的益处和风险将需要持续重新评估。
