本文采用前瞻性、开放试验评价了静注alteplase对大面积急性肺栓塞的疗效和安全性。研究对象为54例急性肺栓塞病人,Miller血管造影指数均≥20,均无溶栓禁忌症。所有病人经周围静脉在10分钟内弹丸样注射本品1m∥kg[平均67(50～100)mg]。静注结束后再以每日400 IU/kg持续静滴肝素,使激活的部分凝血酶时间较对照值延长2～3倍。入院后5～10天开始口服华法林,出院时所有幸存者均在口服抗凝药.给药前、给药后42～54小时和给药后7～21天分别行肺灌注扫描。结果给药后48小时和10天时,灌注缺损的平均绝对值改善率分别为11%和 This prospective, open-label trial evaluated the efficacy and safety of intravenous alteplase in large-area acute pulmonary embolism. The subjects were 54 patients with acute pulmonary embolism, Miller angiography index were ≥ 20, no thrombolytic contraindications. All patients through the peripheral vein within 10 minutes bolus injection of the goods 1m∥kg [average 67 (50 ~ 100) mg]. After intravenous infusion of 400 IU / kg per day continued intravenous infusion of heparin, activated partial thromboplastin time than the control value of 2 to 3 times. Warfarin was given orally 5 to 10 days after admission, and all survivors were given anticoagulants orally before discharge. Lung perfusion scans were performed 42 to 54 hours after drug administration and 7 to 21 days after drug administration. Results At 48 hours and 10 days after administration, the average absolute improvement rates of perfusion defects were 11% and