Goldhaber S Z, Vaughan D E, Markis J E, Selwyn A P, Meyerovitz M F, Loscalzo J, Kim D S, Kessler C M, Dawley D L, Sharma G V
Lancet. 1986 Oct 18;2(8512):886-9. doi: 10.1016/s0140-6736(86)90411-3.
Recombinant human tissue-type plasminogen activator (rt-PA) was given via a peripheral vein to 36 patients with angiographically documented pulmonary embolism. The regimen was 50 mg/2 h followed by repeat angiography and, if necessary, an additional 40 mg/4 h. By 6 h, 34 of 36 patients had angiographic evidence of clot lysis, slight in 4, moderate in 6, and marked in 24. The quantitative score improved 21% by 2 h and 49% by 6 h. Fibrinogen decreased 30% from baseline at 2 h and 38% from baseline at 6 h. 2 patients had major complications: in one, bleeding from a pelvic tumour required surgery; in the other, who had had coronary artery bypass surgery eight days earlier, pericardial tamponade developed. These initial results in selected patients make a case for expanded investigational use of peripheral intravenous rt-PA in pulmonary embolism.
通过外周静脉给36例经血管造影证实为肺栓塞的患者使用重组人组织型纤溶酶原激活剂（rt-PA）。给药方案为50mg/2小时，随后重复血管造影，必要时追加40mg/4小时。至6小时时，36例患者中有34例有血管造影显示血栓溶解的证据，其中4例为轻度溶解，6例为中度溶解，24例为显著溶解。定量评分在2小时时提高了21%，在6小时时提高了49%。纤维蛋白原在2小时时较基线下降了30%，在6小时时较基线下降了38%。2例患者出现严重并发症：1例盆腔肿瘤出血需要手术；另1例在8天前接受了冠状动脉搭桥手术，发生了心包填塞。这些在特定患者中的初步结果为扩大外周静脉rt-PA在肺栓塞中的研究性应用提供了依据。
