Sylvén C, Karlberg K E, Chen J, Hagerman I, Egberg N, Bergström K
Karolinska Institute, Department of Medicine, Huddinge University Hospital, Sweden.
J Intern Med. 1992 Jun;231(6):595-600. doi: 10.1111/j.1365-2796.1992.tb01245.x.
The aim of this study was to determine whether platelets are activated and aggregation is increased in myocardial infarction treated with streptokinase. Twelve consecutive patients were studied. Before streptokinase infusion (1.5 x 10(6) IU i.v. over a period of 1 h), 7 +/- 4 h after the onset of symptoms, fibrinogen, leucocyte and platelet functions were enhanced compared to reference values. Plasma fibrinogen was 3.1 +/- 0.6 g 1-1 (P less than 0.03), leucocyte count was 14.3 +/- 3.3 x 10(3) l-1 (P less than 0.0005), elastase was 39 +/- 8 micrograms l-1 (P less than 0.0002), beta-thromboglobulin was 68 +/- 71 micrograms 1-1 (P less than 0.0001) and filtragometer platelet aggregation time was 137 +/- 40 s (P less than 0.0001). After streptokinase the leucocyte count, elastase and beta-thromboglobulin levels increased further, by about 40% (P less than 0.02), 130% (P less than 0.02) and 140% (P less than 0.005), respectively. Fibrinogen was almost eliminated. Despite signs of increased activation, platelet aggregation was decreased as indicated by both filtragometer aggregation time, which increased by about 480% (P less than 0.003), and whole-blood aggregometry, in which electrical impedance decreased by about 65% (P less than 0.01).
本研究的目的是确定在接受链激酶治疗的心肌梗死患者中血小板是否被激活以及聚集是否增加。对12例连续患者进行了研究。在输注链激酶（1.5×10⁶IU静脉注射，持续1小时）前，症状发作后7±4小时，与参考值相比，纤维蛋白原、白细胞和血小板功能增强。血浆纤维蛋白原为3.1±0.6g/L（P＜0.03），白细胞计数为14.3±3.3×10³/L（P＜0.0005），弹性蛋白酶为39±8μg/L（P＜0.0002），β-血小板球蛋白为68±71μg/L（P＜0.0001），滤过计血小板聚集时间为137±40秒（P＜0.0001）。链激酶治疗后，白细胞计数、弹性蛋白酶和β-血小板球蛋白水平进一步升高，分别升高约40%（P＜0.02）、130%（P＜0.02）和140%（P＜0.005）。纤维蛋白原几乎被清除。尽管有激活增加的迹象，但滤过计聚集时间增加约480%（P＜0.003）以及全血凝集测定中电阻抗降低约65%（P＜0.01）均表明血小板聚集减少。
