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冠状动脉溶栓法正成为急性心肌梗塞的一项开创性治疗。如能尽可能早的给予这种治疗,可使闭塞的冠状动脉再通,从而改善心肌功能,减少死亡率。现在已经证明链球菌激酶、甲氧苯甲酰化血纤维蛋白溶酶原链球菌激酶活化剂复合物(APSAC)和重组性组织型血纤维蛋白溶酶原活化剂(rt-PA)都能减少急性心肌梗塞病人的死亡率。从生化观点看,rt-PA 有几个引人注目的特性。在血液中它如同或类似生理性血纤维蛋白溶酶原活化剂,不会引起抗体反应。并比已知的大多数,或目前所有常用的溶栓剂具有更多的纤维素特性。它可使已闭塞的冠状动脉的再灌率达60～80%。与尿激酶比较疗效相同。但对阻塞动脉的早期再灌比链球菌激酶更为有效。对左心室机能和减少住院病人的死亡率方面,它们的作用相类似。要对这些有效的溶栓剂做出科学的有效的临床评价之前,还需作大量的直接性的比较实验。rt-PA 利用重组DNA 技术治疗血栓性疾病是一重大贡献。因为在西方社会,这种疾病是引起死亡和残疾的主要原因。药效学特性临床应用的rt-PA 是由一种经正常人类
Coronary thrombolysis is becoming a groundbreaking treatment for acute myocardial infarction. If this treatment can be given as early as possible, can make occlusion of the coronary artery recanalization, thereby improving myocardial function, reduce mortality. It has now been demonstrated that both streptokinase, the anisoylated Plasminogen streptokinase activator complex (APSAC), and the recombinant tissue-type plasminogen activator (rt-PA) have been shown to reduce Acute myocardial infarction in patients with mortality. From biochemical point of view, rt-PA has several attractive features. It acts like or similar to a physiologic plasminogen activator in the blood that does not elicit an antibody response. And has more cellulose properties than most known, or all current thrombolytic agents. It allows occlusion of coronary artery reperfusion rate of 60 to 80%. The same effect with urokinase. But is more effective at blocking early arterial reperfusion than streptokinase. Their role is similar to left ventricular function and to reducing mortality in hospitalized patients. A large number of direct comparative trials are required before making a valid scientific clinical evaluation of these effective thrombolytic agents. rt-PA using recombinant DNA technology for the treatment of thrombotic diseases is a major contribution. Because in western societies this disease is the leading cause of death and disability. Pharmacodynamics The clinical application of rt-PA is made by a normal human