Eisenberg P R
Washington University School of Medicine, Cardiovascular Division, St. Louis, Missouri.
Z Kardiol. 1993;82 Suppl 2:175-8.
The benefits of coronary thrombolysis appear to depend primarily on achieving and maintaining coronary artery patency. Unfortunately, failure of coronary thrombolysis or recurrent occlusion may occur in up to 40% of patients treated with fibrinolytic agents. Results of recent studies suggest that recurrent thrombosis may be due to multiple factors including: plasmin-mediated activation of the coagulation system, procoagulant activity of the residual thrombus, presence of high shear forces that promote platelet deposition, and attenuation of physiologic fibrinolytic activity after pharmacologic thrombolysis. Preliminary data suggest that recently developed novel anticoagulants and antiplatelet agents may improve the rate of initial recanalization and prevent recurrent thrombus.
冠状动脉溶栓的益处似乎主要取决于实现并维持冠状动脉通畅。不幸的是，接受纤维蛋白溶解剂治疗的患者中，高达40%可能会出现冠状动脉溶栓失败或再发闭塞。近期研究结果表明，再发血栓形成可能由多种因素导致，包括：纤溶酶介导的凝血系统激活、残余血栓的促凝活性、促进血小板沉积的高剪切力的存在，以及药物溶栓后生理性纤溶活性的减弱。初步数据表明，最近研发的新型抗凝剂和抗血小板药物可能会提高初始再通率并预防血栓再发。
