[Assessment of treatment regimens in 58 cases with acute pulmonary embolism].
OBJECTIVE
To explore the best regimen of treatment for acute pulmonary embolism(APE), and to evaluate the efficacy and safety of 2-h infusion of recombinant tissue-type plasminogen activator, Alteplase (rt-PA) and urokinase(UK).


METHODS
Fifty-eight patients with APE diagnosed by perfusion lung scanning (ECT) or angiography(CPA) were treated with different regimens: i.e. 2-h infusion of rt-PA or UK (2-h group); low doses of UK for 3-7 days (Qd group); anticoagulants alone and thromboectomy. The results were compared.


RESULTS
Of the 41 patients treated with thrombolytic therapy 78% showed improvement in lung perfusion scan and clinical presentation without severe adverse effects, the percentage was significantly higher than that of the anticoagulant group(P < 0.001). The rate of improvement was 84% if thrombolytic therapy was given in 2 h. The mortality rate was lower than anticoagulants and thromboectomy group. The success rate of thromboectomy was 40%.


CONCLUSIONS
A 2 h regimen of rt-PA or UK showed reliable efficacy and safety for treatment of APE. The indication of thrombolytic therapy can be extended. Mortality and morbidity could be reduced if thrombolytic therapy followed by anticoagulation is applied as early as possible.
Liang
Y
Y
Beijing Anzhen Hospital, Beijing 100029, China.
Yang
J
J
Liu
S
S
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000188:drug therapy* / Q000401:mortality; D011994:Recombinant Proteins / Q000627:therapeutic use; D015996:Survival Rate; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator