Improvement of regional myocardial metabolism after coronary thrombolysis induced with tissue-type plasminogen activator or streptokinase.

Improvement of regional myocardial metabolism after coronary thrombolysis induced with tissue-type plasminogen activator or streptokinase.
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组织型纤溶酶原激活剂或链激酶诱导冠状动脉溶栓后局部心肌代谢的改善。

DOI:
10.1161/01.cir.69.5.983
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发表时间:
1984
期刊:
影响因子:
37.8
通讯作者:
Ludbrook,PA
Ludbrook,PA
中科院分区:
医学1区
文献类型:
--
作者:
Sobel,BE;Geltman,EM;Tiefenbrunn,AJ;Jaffe,AS;SpadaroJr,JJ;Ter-Pogossian,MM;Collen,D;Ludbrook,PA

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为了评估组织型纤溶酶原激活剂(t-PA)或链激酶(SK)诱导的冠状动脉溶栓对心脏本身的影响,我们对19例首次透壁性心肌梗死患者在入院后立即进行了11 C-棕榈酸盐正电子发射断层扫描,并在冠状动脉内给予t-PA(n = 2)或SK(n = 17)后48至72小时内再次进行。尽管平均剂量为336,000 IU,足以显著消耗纤维蛋白原,但8例接受SK治疗的患者中凝块持续存在。在没有溶解的情况下,没有发生有利的断层扫描变化。相比之下,在11名诱导溶解的患者中(2名t-PA患者和9名SK患者),与早期研究相比,晚期11 C-棕榈酸酯的心肌蓄积平均改善了29%(p <0.001)。前壁和下壁梗死患者的结果相似。因此,无论是t-PA或SK诱导凝块溶解导致改善局部心肌代谢。
To assess the effects on the heart itself of coronary thrombolysis induced with either tissue-type plasminogen activator (t-PA) or streptokinase (SK), we performed positron emission tomography with 11C-palmitate in 19 patients with initial transmural myocardial infarction immediately after admission and again within 48 to 72 hr after intracoronary administration of t-PA (n = 2) or SK (n = 17). Clots were persistent in eight patients treated with SK despite an average dose of 336,000 IU, sufficient to markedly deplete fibrinogen. In the absence of lysis, favorable tomographic changes did not occur. In contrast, in each of the 11 patients in whom lysis was induced (two with t-PA and nine with SK) myocardial accumulation of 11C-palmitate improved by an average of 29% in late compared with early studies (p less than .001). Results were comparable in patients with anterior and those with inferior infarction. Thus clot lysis induced with either t-PA or SK led to improved regional myocardial metabolism.
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