Vujic I, Young J W, Gobien R P, Dawson W T, Liebscher L, Shelley B E
Radiology. 1983 Sep;148(3):671-5. doi: 10.1148/radiology.148.3.6878682.
Three patients with massive pulmonary embolism were treated with low-dose streptokinase (delivered topically via the pulmonary artery) and simultaneous full-dose heparin. In two patients with acute emboli, rapid but incomplete lysis was observed over 15-30 hours. In one patient with recurrent embolization over three weeks, the major embolus shrank considerably. Pulmonary artery pressure and angiographic findings improved significantly in both patients with acute emboli. In the patient with old embolus, pulmonary artery pressure did not improve despite considerable improvement in angiographic findings and arterial PO2. These data suggest that early topical administration of low-dose streptokinase plus full-dose heparin may be the treatment of choice for patients with massive pulmonary embolism, particularly those with compromised cardiopulmonary status.
三名大面积肺栓塞患者接受了低剂量链激酶治疗（经肺动脉局部给药）并同时使用全剂量肝素。在两名急性栓子患者中，在15 - 30小时内观察到快速但不完全的溶解。在一名三周内反复发生栓塞的患者中，主要栓子明显缩小。两名急性栓子患者的肺动脉压力和血管造影结果均有显著改善。在患有陈旧栓子的患者中，尽管血管造影结果和动脉血氧分压有相当大的改善，但肺动脉压力并未改善。这些数据表明，早期局部给予低剂量链激酶加全剂量肝素可能是大面积肺栓塞患者的首选治疗方法，尤其是那些心肺功能受损的患者。
