Neĭmark M I, Akatov A V
Angiol Sosud Khir. 2010;16(4):43-6.
To avoid the characteristic for thrombolytic therapy of pulmonary embolism problems associated with low efficacy and elevated danger haemorrhagic complications may, in our opinion, be possible by means of the method of local thrombolysis worked out in our Clinic (RF Patent No 2376042). The present work was aimed at assessing efficacy of local thrombolysis in patients diagnosed as having pulmonary artery embolism with the drugs urokinase and actilyse. We examined a total of twenty patients. Ten Group One patients underwent local thrombolysis with Urokinase, and the remaining ten Group Two patients were treated with actilyse. We studied the parameters of central and pulmonary haemodynamics. Local thrombolysis with urokinase and actilyse in patients with pulmonary artery embolism turned out to equally efficiently reestablish blood flow in the pulmonary artery, which was confirmed by normalization of central haemodynamics maximally 2 hours after carrying out thrombolytic therapy with urokinase, with acktilyse accelerating this process to take 1 hour only. The proposed method makes it possible to decrease the dose of fibrinolytic agents twofold as compared with the recommended guidelines of the Pharmacopoeia, without losing their efficacy and ensures prevention of haemorrhagic complications.
我们认为,为避免肺栓塞溶栓治疗存在的疗效低及出血并发症风险高的问题,采用我们诊所研发的局部溶栓方法(俄罗斯联邦专利号2376042)或许可行。本研究旨在评估用尿激酶和阿替普酶对诊断为肺动脉栓塞的患者进行局部溶栓的疗效。我们共检查了20例患者。第一组10例患者接受尿激酶局部溶栓,其余10例第二组患者用阿替普酶治疗。我们研究了中心和肺血流动力学参数。对肺动脉栓塞患者用尿激酶和阿替普酶进行局部溶栓,结果显示二者在恢复肺动脉血流方面同样有效,这在用尿激酶进行溶栓治疗后最长2小时中心血流动力学恢复正常得到证实,而用阿替普酶则将这一过程加速至仅需1小时。与药典推荐指南相比,该方法可将纤溶药物剂量减半,且不影响疗效,并确保预防出血并发症。