Karpov R S, Markov V A, Danilenko A M, Varvarenko V I, Zakharova R M, Dzhavadov K Iu, Radionov V M, Fedorov A Iu, Maksimov I V
Kardiologiia. 1992 Sep;32(9-10):23-6.
The efficacy and risk of prehospital thrombolysis for acute myocardial infarction (MI) were evaluated in a randomized trial. Patients received streptokinase, 500,000 U, and heparin, 10,000 U, intravenously within 5-10 minutes before (Group 1, n = 50) or after (Group 2, n = 50) hospital admission. One hundred patients took conventional therapy (Group 3). The mean time interval between the onset of symptoms and thrombolytic therapy was 2.2, 4.5, and 3.8 hours in Groups 1, 2, and 3, respectively (p < 0.001). Severe hemorrhages were absent. The rate of ventricular fibrillation was the same in Groups 1 and 3 prior to hospitalization. Left ventricular contractility was identical in Groups 1 and 2. By the end of the fourth week, Group 1 showed a 14% increase in ejection fraction and a 14.5% decrease in akinetic segment, these parameters substantially unchanged in Group 2. The MI size assessed by ECG and the maximum myoglobin concentrations was significantly less in Group 1 than that in Group 2. The patients from Group 1 had fewer MI complications than those from Groups 2 and 3. Three patients died in Group 1, 6 in Group 2, and 16 in Group 3. (p < 0.05).
在一项随机试验中评估了院前溶栓治疗急性心肌梗死（MI）的疗效和风险。患者在入院前5 - 10分钟内（第1组，n = 50）或入院后（第2组，n = 50）静脉注射链激酶500,000 U和肝素10,000 U。100例患者接受传统治疗（第3组）。第1、2和3组症状发作至溶栓治疗的平均时间间隔分别为2.2、4.5和3.8小时（p < 0.001）。未出现严重出血。第1组和第3组住院前室颤发生率相同。第1组和第2组左心室收缩力相同。到第四周末，第1组射血分数增加14%，运动不能节段减少14.5%，第2组这些参数基本未变。通过心电图评估的心肌梗死面积和最大肌红蛋白浓度，第1组显著小于第2组。第1组患者的心肌梗死并发症少于第2组和第3组。第1组3例死亡，第2组6例死亡，第3组16例死亡。（p < 0.05）
