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在大规模肺栓塞的治疗中,用tenecteplase与alteplase的死亡率结果与alteplase对比
Luke R Murphy1, Adam Singer2, Brandon Okeke3
1Department of Emergency Medicine, University of Texas Medical Branch at Galveston, Galveston, Texas.
The Journal of emergency medicine
|September 5, 2024
概括
甲 (TNK) 和高甲在肺栓塞 (PE) 治疗中显示了类似的30天死亡率. 这种现实世界的证据支持TNK作为一种潜在的替代血栓溶解剂.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 肺栓塞 (PE) 是急诊室访问的常见原因之一.
- 对于大量PE,建议使用alteplase,但tenecteplase (TNK) 具有潜在的优势.
- 对TNK与PE的alteplase进行比较的研究是有限的.
研究的目的:
- 使用现实数据,比较PE患者TNK和阿尔特的安全性和死亡率.
- 评估包括死亡率,内出血和输血在内的结果.
主要方法:
- 使用TriNetX全球健康研究网络进行的回顾性队列研究.
- 包括年龄在18岁以上的患有PE诊断的患者 (ICD-10 I26).
- 倾向匹配比较了TNK治疗 (266例) 和 alteplase治疗 (22,864例) 队列,评估了30天的结果.
主要成果:
- 30天死亡率在TNK和alteplase队列之间是相似的 (19.4%对19.8%).
- 脑内出血和输血率过于罕见,无法进行分析.
- 队列是可比的后倾向匹配.
结论:
- 在治疗血液动力学不稳定的PE时,TNK的死亡率与阿尔特相似.
- 研究结果表明,TNK 是一种可行的PE初级血栓解压剂.
- 考虑到TNK的成本效益和易于管理,有必要进行前性评估.
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