Coronary thrombolysis with recombinant single-chain urokinase-type plasminogen activator in patients with acute myocardial infarction.
Coronary thrombolysis with recombinant single-chain urokinase-type plasminogen activator in patients with acute myocardial infarction.
复制标题
重组单链尿激酶型纤溶酶原激活剂对急性心肌梗死患者进行冠状动脉溶栓。
作者：
F. Van de Werf;J. Vanhaecke;H. De Geest;M. Verstraete;D. Collen
17例急性透壁性心肌梗死和血管造影证实完全冠状动脉闭塞的患者接受肝素联合静脉注射单链尿激酶型纤溶酶原激活剂（scu-PA）治疗，通过在大肠杆菌中表达编码成熟人scu-PA的cDNA获得。在8例患者中，重组scu-PA（rscu-PA）作为10毫克的推注，然后超过1小时30毫克。再通获得6例患者，但持续延迟混浊的血管在这些患者中的4个。输注期间，血浆中rscu-PA抗原水平达到3.4 μ g/ml（中位数，范围1.4 - 5.5）。输注结束时，α 2-抗纤溶酶水平降至输注前水平的54%（中位数，范围22%-82%），纤维蛋白原水平降至89%（中位数，范围26%-101%），纤维蛋白原降解产物（FDP）降至20 μ g/ml（中位数，范围8 - 387）。在9例患者中，rscu-PA以10 mg推注给药，随后在1小时内给予60 mg。这导致7例患者在46 +/- 17 min（平均值+/- SD）内血管远端充盈正常的再通。输注期间，血浆中rscu-PA的浓度升高至中位数7.4 μ g/ml（范围4.0 - 13.3）。输注结束时，α 2-抗纤溶酶水平为基线的22%（范围5%-47%），纤维蛋白原水平为45%（范围4%-94%），FDP浓度为87 μ g/ml（范围6 - 1034）。没有观察到明显的出血或短期副作用。（250字处删节）
Seventeen patients with acute transmural myocardial infarction and angiographically confirmed complete coronary occlusion were treated with heparin combined with intravenous single-chain urokinase-type plasminogen activator (scu-PA), obtained by expression of the cDNA encoding mature human scu-PA in Escherichia coli. In eight patients, recombinant scu-PA (rscu-PA) was given as a 10 mg bolus followed by 30 mg over 1 hr. Recanalization was obtained in six patients, but with persistent delayed opacification of the vessel in four of these patients. During infusion, a plateau level of rscu-PA antigen in plasma of 3.4 micrograms/ml (median value, range 1.4 to 5.5) was reached. At the end of the infusion the alpha 2-antiplasmin level had decreased to 54% (median, range 22% to 82%) of the preinfusion level, the fibrinogen level to 89% (median, range 26% to 101%), and fibrinogen degradation products (FDPs) to 20 micrograms/ml (median, range 8 to 387). In nine patients, rscu-PA was administered as a 10 mg bolus followed by 60 mg over 1 hr. This resulted in recanalization with normal distal filling of the vessel in seven patients, within 46 +/- 17 min (mean +/- SD). During infusion the concentration of rscu-PA in plasma increased to a median value of 7.4 micrograms/ml (range 4.0 to 13.3). At the end of the infusion the alpha 2-antiplasmin level was 22% of baseline (range 5% to 47%), the fibrinogen level 45% (range 4% to 94%), and the concentration of FDPs 87 micrograms/ml (range 6 to 1034). No significant bleeding or short-term side effects were observed.(ABSTRACT TRUNCATED AT 250 WORDS)