留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

超声辅助导管溶栓在肺血栓栓塞症中的应用进展

张毅 罗勤 赵智慧 赵青 柳志红

张毅, 罗勤, 赵智慧, 赵青, 柳志红. 超声辅助导管溶栓在肺血栓栓塞症中的应用进展[J]. 协和医学杂志, 2022, 13(1): 104-109. doi: 10.12290/xhyxzz.2021-0029
引用本文: 张毅, 罗勤, 赵智慧, 赵青, 柳志红. 超声辅助导管溶栓在肺血栓栓塞症中的应用进展[J]. 协和医学杂志, 2022, 13(1): 104-109. doi: 10.12290/xhyxzz.2021-0029
ZHANG Yi, LUO Qin, ZHAO Zhihui, ZHAO Qing, LIU Zhihong. Advances in Ultrasound-assisted Catheter-directed Thrombolysis for the Treatment of Pulmonary Thromboembolism[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(1): 104-109. doi: 10.12290/xhyxzz.2021-0029
Citation: ZHANG Yi, LUO Qin, ZHAO Zhihui, ZHAO Qing, LIU Zhihong. Advances in Ultrasound-assisted Catheter-directed Thrombolysis for the Treatment of Pulmonary Thromboembolism[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(1): 104-109. doi: 10.12290/xhyxzz.2021-0029

超声辅助导管溶栓在肺血栓栓塞症中的应用进展

doi: 10.12290/xhyxzz.2021-0029
基金项目: 

北京市自然科学基金 7202168

中国医学科学院医学与健康科技创新工程 2020-I2M-C & T-B-055

详细信息
    通讯作者:

    柳志红, E-mail:zhihongliufuwai@163.com

  • 中图分类号: R563.5; R445.1

Advances in Ultrasound-assisted Catheter-directed Thrombolysis for the Treatment of Pulmonary Thromboembolism

Funds: 

Beijing Municipal Natural Science Foundation 7202168

CAMS Innovation Fund for Medical Sciences 2020-I2M-C & T-B-055

More Information
  • 摘要: 肺血栓栓塞症(pulmonary thromboembolism,PTE)是心血管疾病中导致患者死亡的第三大常见原因。在真实世界中,因担心出现大出血等风险,仅20%~30%的高危PTE患者接受了系统性溶栓治疗,虽然中危PTE患者接受系统性溶栓可降低死亡率,但出血风险远高于获益。超声辅助导管溶栓可在血栓部位直接释放溶栓药物,所需药物剂量更低,且超声波可促进血栓溶解,有望成为一种安全、有效的溶栓新手段。本文将介绍超声辅助导管溶栓的机制、所需设备与操作程序、安全性与有效性等,并对未来的研究方向提出展望。
    作者贡献:柳志红、罗勤负责构思论文;罗勤、赵智慧、赵青、张毅负责查阅文献资料;张毅负责撰写论文;柳志红、罗勤、赵智慧、赵青、张毅负责修订论文。
    利益冲突:所有作者均声明不存在利益冲突
  • [1] 孙雪峰, 施举红. 肺栓塞溶栓治疗新理念[J]. 协和医学杂志, 2020, 11: 135-139. doi:  10.3969/j.issn.1674-9081.20190257

    Sun XF, Shi JH. New Principles for Thrombolysis in Pulmonary Embolism[J]. Xiehe Yixue Zazhi, 2020, 11: 135-139. doi:  10.3969/j.issn.1674-9081.20190257
    [2] Zhang Z, Lei J, Shao X, et al. Trends in Hospitalization and In-Hospital Mortality From VTE, 2007 to 2016, in China[J]. Chest, 2019, 155: 342-353. doi:  10.1016/j.chest.2018.10.040
    [3] Keller K, Hobohm L, Ebner M, et al. Trends in thrombolytic treatment and outcomes of acute pulmonary embolism in Germany[J]. Eur Heart J, 2020, 41: 522-529.
    [4] Jiménez D, Bikdeli B, Barrios D, et al. Epidemiology, patterns of care and mortality for patients with hemodynamically unstable acute symptomatic pulmonary embolism[J]. Int J Cardiol, 2018, 269: 327-333. doi:  10.1016/j.ijcard.2018.07.059
    [5] Stein PD, Matta F. Thrombolytic therapy in unstable patients with acute pulmonary embolism: saves lives but underused[J]. Am J Med, 2012, 125: 465-470. doi:  10.1016/j.amjmed.2011.10.015
    [6] Meyer G, Vicaut E, Danays T, et al. Fibrinolysis for patients with intermediate-risk pulmonary embolism[J]. N Engl J Med, 2014, 370: 1402-1411. doi:  10.1056/NEJMoa1302097
    [7] Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)[J]. Eur Heart J, 2020, 41: 543-603. doi:  10.1093/eurheartj/ehz405
    [8] Bader KB, Bouchoux G, Holland CK. Sonothrombolysis[J]. Adv Exp Med Biol, 2016, 880: 339-362.
    [9] Engelberger RP, Kucher N. Ultrasound-assisted thromboly-sis for acute pulmonary embolism: a systematic review[J]. Eur Heart J, 2014, 35: 758-764. doi:  10.1093/eurheartj/ehu029
    [10] Chernysh IN, Everbach CE, Purohit PK, et al. Molecular mechanisms of the effect of ultrasound on the fibrinolysis of clots[J]. J Thromb Haemost, 2015, 13: 601-609. doi:  10.1111/jth.12857
    [11] 钱盛友, 王鸿樟, 孙福成. 声流现象的研究及其应用[J]. 应用声学, 1997, 16: 38-42, 45. doi:  10.11684/j.issn.1000-310X.1997.06.011

    Qian SY, Wang HZ, Sun FC. Acoustic streaming and its applications[J]. Yingyong Shengxue, 1997, 16: 38-42, 45. doi:  10.11684/j.issn.1000-310X.1997.06.011
    [12] 夏青青, 刘俐. 超声联合微泡辅助溶栓的研究进展[J]. 心血管病学进展, 2019, 40: 564-568. https://www.cnki.com.cn/Article/CJFDTOTAL-XXGB201904021.htm

    Xia QQ, Liu L. Ultrasound Combined with Microbubble Assisted Thrombolysis[J]. Xinxueguan Bingxue Jinzhan, 2019, 40: 564-568. https://www.cnki.com.cn/Article/CJFDTOTAL-XXGB201904021.htm
    [13] Goel L, Jiang X. Advances in Sonothrombolysis Techniques Using Piezoelectric Transducers[J]. Sensors (Basel), 2020, 20: 1288. doi:  10.3390/s20051288
    [14] Hobohm L, Keller K, Münzel T, et al. EkoSonic® endovascular system and other catheter-directed treatment reperfusion strategies for acute pulmonary embolism: overview of efficacy and safety outcomes[J]. Expert Rev Med Devices, 2020, 17: 739-749. doi:  10.1080/17434440.2020.1796632
    [15] Engelberger RP, Fahrni J, Willenberg T, et al. Fixed low-dose ultrasound-assisted catheter-directed thrombolysis followed by routine stenting of residual stenosis for acute ilio-femoral deep-vein thrombosis[J]. Thromb Haemost, 2014, 111: 1153-1160. doi:  10.1160/TH13-11-0932
    [16] Herriott B, Mion LC. Nursing Care Practices for Patients With Pulmonary Embolism Undergoing Treatment With Ultrasound-Assisted Thrombolysis: An Integrative Review[J]. J Cardiovasc Nurs, 2020, 35: 386-399. doi:  10.1097/JCN.0000000000000625
    [17] Kucher N, Boekstegers P, Müller OJ, et al. Randomized, controlled trial of ultrasound-assisted catheter-directed thrombolysis for acute intermediate-risk pulmonary embolism[J]. Circulation, 2014, 129: 479-486. doi:  10.1161/CIRCULATIONAHA.113.005544
    [18] Piazza G, Hohlfelder B, Jaff MR, et al. A Prospective, Single-Arm, Multicenter Trial of Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism: The SEATTLE Ⅱ Study[J]. JACC Cardiovasc Interv, 2015, 8: 1382-1392. doi:  10.1016/j.jcin.2015.04.020
    [19] Tapson VF, Sterling K, Jones N, et al. A Randomized Trial of the Optimum Duration of Acoustic Pulse Thromboly-sis Procedure in Acute Intermediate-Risk Pulmonary Embolism: the OPTALYSE PE Trial[J]. JACC Cardiovasc Interv, 2018, 11: 1401-1410.
    [20] Sardar P, Piazza G, Goldhaber SZ, et al. Predictors of Treatment Response Following Ultrasound-Facilitated Catheter- Directed Thrombolysis for Submassive and Massive Pulmonary Embolism: A SEATTLE Ⅱ Substudy[J]. Circ Cardiovasc Interv, 2020, 13: e008747.
    [21] Piazza G, Sterling KM, Tapson VF, et al. One-Year Echocardiographic, Functional, and Quality of Life Outcomes After Ultrasound-Facilitated Catheter-Based Fibrinolysis for Pulmonary Embolism[J]. Circ Cardiovasc Interv, 2020, 13: e009012.
    [22] Avgerinos ED, Saadeddin Z, Abou Ali AN, et al. A meta-analysis of outcomes of catheter-directed thrombolysis for high- and intermediate-risk pulmonary embolism[J]. J Vasc Surg Venous Lymphat Disord, 2018, 6: 530-540. doi:  10.1016/j.jvsv.2018.03.010
    [23] Kaymaz C, Akbal OY, Tanboga IH, et al. Ultrasound-Assisted Catheter-Directed Thrombolysis in High-Risk and Intermediate-High-Risk Pulmonary Embolism: A Meta-Analysis[J]. Curr Vasc Pharmacol, 2018, 16: 179-189. doi:  10.2174/1570161115666170404122535
    [24] Wu J, Chen H, Yu Y, et al. Feasibility of ultrasound-assisted catheter-directed thrombolysis for submassive pulmonary embolism: A meta-analysis of case series[J]. Clin Respir J, 2020, 14: 430-439. doi:  10.1111/crj.13155
    [25] Lin PH, Annambhotla S, Bechara CF, et al. Comparison of percutaneous ultrasound-accelerated thrombolysis versus catheter-directed thrombolysis in patients with acute massive pulmonary embolism[J]. Vascular, 2009, 17: S137-S147. doi:  10.2310/6670.2009.00063
    [26] Rao G, Xu H, Wang JJ, et al. Ultrasound-assisted versus conventional catheter-directed thrombolysis for acute pulmonary embolism: A multicenter comparison of patient-centered outcomes[J]. Vasc Med, 2019, 24: 241-247. doi:  10.1177/1358863X19838334
    [27] Rothschild DP, Goldstein JA, Ciacci J, et al. Ultrasound-accelerated thrombolysis (USAT) versus standard catheter-directed thrombolysis (CDT) for treatment of pulmonary embolism: A retrospective analysis[J]. Vasc Med, 2019, 24: 234-240. doi:  10.1177/1358863X19838350
    [28] 朱琼, 高顺记, 郭梦娇, 等. 血栓内微泡联合尿激酶介导的超声溶栓体外实验[J]. 中国介入影像与治疗学, 2017, 14: 242-246. https://www.cnki.com.cn/Article/CJFDTOTAL-JRYX201704018.htm

    Zhu Q, Gao SJ, Guo MJ, et al. Intraclot microbubble combined with urokinase mediated ultrasound thrombolysis: Experiment in vitro[J]. Zhongguo Jieru Yingxiang Yu Zhiliaoxue, 2017, 14: 242-246. https://www.cnki.com.cn/Article/CJFDTOTAL-JRYX201704018.htm
    [29] 张冰, 王浩. 超声溶栓临床应用的研究进展[J]. 中华医学超声杂志(电子版), 2019, 16: 785-789. doi:  10.3877/cma.j.issn.1672-6448.2019.10.013
    [30] Mathias W Jr, Tsutsui JM, Tavares BG, et al. Diagnostic Ultrasound Impulses Improve Microvascular Flow in Patients With STEMI Receiving Intravenous Microbubbles[J]. J Am Coll Cardiol, 2016, 67: 2506-2515. doi:  10.1016/j.jacc.2016.03.542
  • 加载中
计量
  • 文章访问数:  644
  • HTML全文浏览量:  103
  • PDF下载量:  102
  • 被引次数: 0
出版历程
  • 收稿日期:  2021-01-09
  • 录用日期:  2021-01-25
  • 网络出版日期:  2021-12-16
  • 刊出日期:  2022-01-30

目录

    /

    返回文章
    返回

    【温馨提醒】近日,《协和医学杂志》编辑部接到作者反映,有多名不法人员冒充期刊编辑发送见刊通知,鼓动作者添加微信,从而骗取版面费的行为。特提醒您,本刊与作者联系的方式均为邮件通知或电话,稿件进度通知邮箱为:mjpumch@126.com,编辑部电话为:010-69154261,请提高警惕,谨防上当受骗!如有任何疑问,请致电编辑部核实。谢谢!