Berridge D C, Earnshaw J J, Westby J C, Makin G S, Hopkinson B R
Department of Vascular Surgery, University Hospital, Nottingham, UK.
Thromb Haemost. 1989 Apr 25;61(2):275-8.
Fibrinolytic parameters have been monitored in 44 patients undergoing local low-dose intra-arterial thrombolysis for acute peripheral arterial ischaemia. Streptokinase (Sk), at a dose of 5,000 units/hr with 250 units/hr heparin, was used in 23 patients and recombinant tissue plasminogen activator (r-tPA) at a dose of 0.5 mg/hr was used in 21 patients. Successful lysis was seen in 18 (86%) patients following r-tPA and in 15 (65%) patients following streptokinase. There were 4 minor haematomas in each group usually at the catheter entry site. Both agents produced a systemic effect, which was still seen 12 hours post-infusion. However, that produced by r-tPA was delayed and significantly reduced compared to that produced by Sk. These results confirm the relative fibrin specificity of r-tPA. When used as a continuous low-dose intra-arterial infusion, r-tPA offers a significantly lower, potentially safer, systemic effect than conventional therapy with streptokinase.
对44例接受局部低剂量动脉内溶栓治疗急性外周动脉缺血的患者进行了纤溶参数监测。23例患者使用链激酶（Sk），剂量为5000单位/小时，同时使用肝素250单位/小时；21例患者使用重组组织型纤溶酶原激活剂（r-tPA），剂量为0.5毫克/小时。r-tPA治疗后18例（86%）患者溶栓成功，链激酶治疗后15例（65%）患者溶栓成功。每组均有4例小血肿，通常位于导管插入部位。两种药物均产生全身效应，输液后12小时仍可观察到。然而，与链激酶相比，r-tPA产生的全身效应延迟且显著降低。这些结果证实了r-tPA相对的纤维蛋白特异性。当作为持续低剂量动脉内输注使用时，与链激酶常规治疗相比，r-tPA产生的全身效应显著更低，可能更安全。
