Intravenöse Thrombolysetherapie des akuten Herzinfarktes

D. C. Gulba; M. Sosada; P. R. Lichtlen

doi:10.1055/s-0038-1660319

Hämostaseologie, Table of Contents

Hamostaseologie 1992; 12(02): 073-081
DOI: 10.1055/s-0038-1660319

Übersichtsarbeit/Review Articles

Schattauer GmbH

Intravenöse Thrombolysetherapie des akuten Herzinfarktes

Aktueller Stand 1992

D. C. Gulba

¹Medizinische Hochschule Hannover, Zentrum Innere Medizin und Dermatologie, Abt. Kardiologie (Leiter: Prof. Dr. P. R. Lichtlen)

,

M. Sosada

²Medizinische Hochschule Hannover, Zentrum Innere Medizin und Dermatologie, Abt. Hämatologie und Onkologie (Leiter: Prof. Dr. H. Poliwoda)

,

P. R. Lichtlen

¹Medizinische Hochschule Hannover, Zentrum Innere Medizin und Dermatologie, Abt. Kardiologie (Leiter: Prof. Dr. P. R. Lichtlen)

› Author Affiliations

Abstract

Zusammenfassung

Die intravenöse Thrombolysetherapie kann, insbesondere bei frühzeitigem Einsatz, die Sterblichkeit beim akuten Herzinfarkt wesentlich vermindern. Derzeit stehen vier unterschiedliche Thrombolytika (Streptokinase, APSAC, Urokinase und rt-PA) kommerziell zur Verfügung. Im klinischen Gebrauch unterscheiden sie sich insbesondere in der Geschwindigkeit, mit der sie die Thrombolyse herbeiführen, und in ihrer Fibrinspezifität. Inwieweit diese unterschiedlichen Eigenschaften die Prognose der Patienten wesentlich beeinflussen, wird derzeit noch kontrovers diskutiert.

Sofern Urokinase oder rt-PA zum Einsatz kommen, ist eine begleitende Heparintherapie unerläßlich. Um späteren Reinfarkten vorzubeugen, sollte - in Abhängigkeit vom klinischen Verlauf des Patienten - vor der Entlassung aus dem Krankenhaus oder im stabilen Intervall eine invasive Diagnostik mittels Herzkatheter und bei Vorhandensein höhergradiger Stenosen eine Dilatationsbehandlung oder Bypass-Operation durchgeführt werden.

Schlüsselwörter

Thrombolyse - Herzinfarkt - Heparin - Thrombolytika - Reperfusion

Keywords

Thrombolysis - myocardial infarction - heparin - thrombolytic agents - reperfusion

Full Text

References

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