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一、关于血流的再开通率据统计,在日本,尿激酶(UK)冠状动脉内给药(发病6小时以内的病例)72万单位,开通率为64.5%;给96万单位,开通率为73.8%;静脉注射96万单位,开通率仅为50%,较低。在国外,给予组织纤维蛋白原激酶(tissue plasminogen activator,t-PA)静注,结果为60～70%。即,冠脉内给药为75%左右,静注法为60～70%。二、冠脉内血检溶解疗法后的再闭塞率Harrison 等报告,血栓溶解疗法后的冠脉造影,横断面积在0.4mm~2以下的占54%,0.4mm~2以上的都没有再发生血栓。造影显示,狭窄度90%以上的血栓再发为41%,而90%以下的无再闭塞。根据Bodger 等报告,使用SK(链激酶)冠状动脉内给药后冠脉造影显示,内径0.6mm 以下的占42%,12个月后死亡率:内径0.6mm以下的为28%,0.6mm 以上的为7%;血流改善充分的(TIMI 实验血流再开通标准Ⅲ级),死亡率为8%,不充分的(Ⅰ～Ⅱ级),为37%。
First, on the reopening rate of blood flow According to statistics, in Japan, urokinase (UK) intracoronary administration (cases within 6 hours of onset) 720,000 units, the opening rate was 64.5%; to 960,000 units, the opening rate 73.8%; intravenous 960,000 units, the opening rate was only 50%, lower. In other countries, tissue plasminogen activator (t-PA) was administered intravenously with the result of 60-70%. That is, the intracoronary administration is about 75% and the intravenous injection is 60% to 70%. Second, the rate of reocclusion after coronary blood lysate therapy Harrison et al reported that coronary angiography after thrombolytic therapy, cross-sectional area of 0.4mm ~ 2 accounted for 54%, 0.4mm ~ 2 above no recurrence thrombus. Angiography showed that more than 90% of stenosis thrombus recurrence was 41%, while 90% of the following no occlusion. According to a report by Bodger et al., Coronary angiography after administration of SK (streptokinase) intracoronary administration showed that 42% of the patients had an inner diameter of 0.6 mm or less and 12 months of death after the autoimmune treatment of 28% or more of the patients with an inner diameter of 0.6 mm or more and 0.6 mm or more (7%). The blood flow was improved (TIMI flow was reopened to standard grade III) with a mortality rate of 8% and inadequate (grade Ⅰ ~ Ⅱ) of 37%.