急性大面积肺栓塞的重组组织型纤溶酶原激活剂静脉溶栓治疗  

INTRAVENOUS RECOMBINANT TISSUE-TYPE PLASMINOGEN ACTIVATOR FOR ACUTE MASSIVE PULMONARY EMBOLISM

作　　者：陈白屏[1] 赵彦芬[1] 程显声[1] 高润霖[1] 刘秀杰[1] 史蓉芳[1] 刘蕴忠 张晓莉 戴汝平[1] 谢若兰[1] 曾峥 鲍飞 祁哲[1] 毛克修 李长瑞[1] 张荫风 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所,中国医学科学院中国协和医科大学阜外心血管病医院

出　　处：《中国循环杂志》1995年第6期364-367,共4页Chinese Circulation Journal

摘　　要：本文报道１例急性肺栓塞采用^（９９ｍ）Ｔｃ－Ｐ３５７标测肺动脉内新鲜血栓，并进行肺动脉造影，显示大块新鲜血栓堵塞于左、右肺动脉干的急性大面积肺栓塞，肺动脉压中度升高。选用重组组织型纤溶酶原激活剂（ｒｔ－ＰＡ）进行静脉溶栓治疗。溶栓后再次行肺动脉造影，结果显示大块血栓基本溶解，部分肺动脉的小分支内仍有残余血栓，肺动脉压降至正常。本例表明，急性肺栓塞如能得到及时诊断和治疗，可迅速逆转大面积肺栓塞所致的血液动力学障碍，^（９９ｍ）Ｔｃ－Ｐ３５７是最先进的、准确的诊断急性肺栓塞的检测手段，ｒｔ－ＰＡ是一安全、有效的溶栓药物。patient of acute massive pulmonary embolism with moderately elevated pulmonary arterial pressure (PAP) proved by￣(99m) Tc-P357 scintigraphy and pulmonary arteriography was treated by intravenous recombinant tissue-type plasminogen activator (rt-PA).A total dose of 100 mg rt-PA was used by an initial infusion of 10 mg within 5 min followed by 20 mg/hr for 2 hrs and 10 mg/hr for 5 hrs. 12 hrs after thrombolysis , the patient was re-examined by pulmonary arteriography. The result showed that most of the thrombi were lysed and the PAP returned to normal. In conclusion , rt-PA is an effective and safe agent for thrombolysis and ￣(99m) Tc-P357 scintigraphy is an accurate method for the diagnosis of acute pulmonary embolism.

关 键 词：肺栓塞 溶栓疗法 纤溶酶原激活剂 药物疗法 

分 类 号：R563.505[医药卫生—呼吸系统]