Department of Internal Medicine, Vinzentius-Hospital, Landau, Germany.
Int J Gen Med. 2012;5:183-6. doi: 10.2147/IJGM.S29200. Epub 2012 Feb 28.
Alteplase (recombinant tissue plasminogen activator) has been used in the treatment of acute ischemic stroke for 10 years. The application of this drug is considered safe and effective. However, alteplase is also associated with side effects. The author is reporting on an unusual side effect of angioedema that is triggered by alteplase. Angioedema occurs through alteplase according to this study at a frequency of 5.88% (95% confidence interval: 0.98% to 28.76%). In this case immunoglobulin G was slightly increased. The relative risk to get an angioedema compared between the two genders is elevated in men 3.3 (95% confidence interval: 0.15% to 71.90%; P = 0.4423), who were 3.3 times more likely to suffer than women. The use of angiotensin-converting-enzyme (ACE) inhibitors is considered a possible risk factor for the occurrence of angioedema with concomitant administration of tissue plasminogen activator. The angioedema may occur with use of alteplase at any time, so treatment with this drug must always be carried out in intensive care and doctors must be ready for intubation if necessary.
阿替普酶（重组组织型纤溶酶原激活剂）已在急性缺血性脑卒中的治疗中应用了 10 年。该药的应用被认为是安全有效的。但是，阿替普酶也存在一些副作用。作者报告了一例由阿替普酶引发的罕见血管性水肿的不良反应。根据这项研究，血管性水肿的发生率为 5.88%（95%置信区间：0.98%至 28.76%）。在本例中，免疫球蛋白 G 略有升高。与女性相比，男性发生血管性水肿的相对风险升高 3.3 倍（95%置信区间：0.15%至 71.90%；P=0.4423）。性别被认为是血管性水肿发生的一个可能危险因素，与同时使用血管紧张素转换酶（ACE）抑制剂有关。阿替普酶可随时引发血管性水肿，因此，必须在重症监护下使用该药进行治疗，如果有必要，医生必须做好插管的准备。
