Cutler D, Bode C, Runge M S
Cardiology Division, University of Texas Medical Branch, Galveston 77555-0558, USA.
J Vasc Interv Radiol. 1995 Nov-Dec;6(6 Pt 2 Suppl):3S-7S. doi: 10.1016/s1051-0443(95)71241-6.
The therapeutic efficacy of thrombolytic therapy for the treatment of acute myocardial infarction was first demonstrated convincingly in 1985 by the GISSI investigators. In the ensuing 10 years, continued clinical investigation has focused on improving the safety and efficacy of thrombolytic therapy. In addition to the use of adjunctive agents such as inhibitors of platelet aggregation and thrombin, new genetically engineered "second-generation" thrombolytic agents have been developed that offer the promise of improved clinical outcomes. The availability of these potent agents for clinical investigation offers the opportunity to determine the importance of properties such as fibrin specificity, plasma half-life, and resistance to inhibition. This review focuses on theoretical and practical aspects of optimizing thrombolytic therapy, survey of new agents on the clinical horizon, and the potential application of these agents for the treatment of patients with thrombotic occulusion of either coronary or peripheral arteries.
1985年，GISSI研究人员首次令人信服地证明了溶栓疗法治疗急性心肌梗死的疗效。在随后的10年里，持续的临床研究集中在提高溶栓疗法的安全性和疗效上。除了使用辅助药物如血小板聚集抑制剂和凝血酶抑制剂外，还开发了新的基因工程“第二代”溶栓剂，有望改善临床结局。这些强效药物可供临床研究，为确定纤维蛋白特异性、血浆半衰期和抗抑制性等特性的重要性提供了机会。本综述重点关注优化溶栓疗法的理论和实践方面、对即将出现的新型药物的综述，以及这些药物在治疗冠状动脉或外周动脉血栓闭塞患者中的潜在应用。
