首页> 外文期刊>Journal of endovascular therapy: an official journal of the International Society of Endovascular Specialists >Safety of thrombolytic therapy with urokinase or recombinant tissue plasminogen activator for peripheral arterial occlusion: a comprehensive compilation of published work.
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Safety of thrombolytic therapy with urokinase or recombinant tissue plasminogen activator for peripheral arterial occlusion: a comprehensive compilation of published work.

机译:用尿激酶或重组组织纤溶酶原激活剂进行溶栓治疗周边动脉闭塞的安全性:已发表著作的综合汇编。

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Purpose: To report a comprehensive literature review focused on comparing the risk of complications with urokinase versus recombinant tissue plasminogen activator (rtPA) for thrombolytic treatment of peripheral arterial occlusions.Methods: The English-language literature between 1985 and 2002 was searched for studies that used tissue-derived urokinase or rtPA in the treatment of peripheral arterial occlusions. Forty-eight studies (22 urokinase, 22 rtPA, and 4 that included both treatments) were identified, encompassing 2226 urokinase-treated patients and 1927 rtPA-treated patients. The safety of each thrombolytic agent was assessed based on the incidence of major hemorrhage, intracerebral hemorrhage, major limb amputation, transfusions, and mortality.Results: The review revealed a wide range of study protocols, patient conditions, ages of occlusions, dosages/delivery methods of lytic agents, and criteria for reporting complications. The incidence of major hemorrhage varied widely, but the overall rate was lower among urokinase-treated patients (6.2%) than for patients treated with rtPA (8.4%, p=0.007). The overall incidence of intracerebral hemorrhage was also significantly lower for urokinase (0.4% versus 1.1% for rtPA, p=0.020). The major amputation rate was similar for both treatments (urokinase 7.9%, rtPA 7.2%), but the mortality rate was significantly lower for urokinase (3.0% versus 5.6% for rtPA, p<0.001). The need for transfusions was less frequent with urokinase (11.1% versus 16.1%, p=0.002).Conclusions: These results from a large body of published literature suggest that urokinase may be associated with a lower incidence of complications than rtPA in the treatment of peripheral arterial occlusions.
机译:目的:报道全面的文献综述,侧重于比较尿激酶与重组组织纤溶酶原激活剂(rtPA)对外周动脉闭塞进行溶栓治疗的并发症风险。方法:从1985年至2002年的英语文献中进行研究组织来源的尿激酶或rtPA在治疗周围动脉阻塞中的作用。确定了四十八项研究(22种尿激酶,22 rtPA和4种包括两种治疗方法),包括2226例尿激酶治疗的患者和1927例rtPA治疗的患者。根据主要出血,脑内出血,大肢截肢,输血和死亡率的发生率评估每种溶栓剂的安全性。结果:该评价揭示了广泛的研究方案,患者状况,闭塞年龄,剂量/分娩时间溶解剂的方法以及报告并发症的标准。严重出血的发生率差异很大,但尿激酶治疗的患者(6.2%)的总发生率低于rtPA治疗的患者(8.4%,p = 0.007)。尿激酶脑出血的总发生率也显着降低(rtPA为0.4%,而rtPA为1.1%,p = 0.020)。两种治疗的主要截肢率相似(尿激酶7.9%,rtPA 7.2%),但尿激酶的死亡率显着降低(rtPA的死亡率为3.0%vs 5.6%,p <0.001)。结论尿激酶输注的频率降低了(11.1%对16.1%,p = 0.002)。结论:大量已发表文献的结果表明,与rtPA相比,尿激酶治疗并发症的发生率较低。周围动脉阻塞。

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