Oltrona L, Merlini P A, Ladelli L M, Granata D, Lombardo M, Dossena M, Sali M, Campolo L, Belli C
Dipartimento Cardiologico De Gasperis, Ospedale Niguarda, Milano, Italy.
J Cardiovasc Pharmacol. 1991;18 Suppl 9:S61-3.
We evaluated the effect of three different anti-ischemic therapeutic regimens on ventricular arrhythmias in 25 patients hospitalized for unstable angina. All patients were randomized to receive (in addition to infusion of heparin, diltiazem, and nitrates), either placebo, or streptokinase (SK) 1,500,000 U in 1 h, or SK 250,000 U in 30 min followed by 100,000 U/h for 48 h. Patients underwent ECG monitoring during the first 72 h after admission and for 24 h after 15 days of oral therapy with diltiazem, aspirin, and transdermal nitrates. Premature ventricular complexes (PVC) and ventricular tachycardia episodes (VT) were significantly reduced during the early phase of hospitalization and after 15 days, in patients treated with prolonged SK infusion. Ventricular arrhythmias are a frequent finding in unstable angina; they are correlated neither to the severity of coronary disease nor to ventricular function; prolonged infusion of SK added to heparin, diltiazem, and nitrates seems to reduce the number and severity of ventricular arrhythmias.
我们评估了三种不同的抗缺血治疗方案对25例因不稳定型心绞痛住院患者室性心律失常的影响。所有患者均被随机分配接受（除输注肝素、地尔硫䓬和硝酸盐外）安慰剂，或1小时内静脉输注链激酶（SK）150万单位，或30分钟内静脉输注SK 25万单位，随后48小时内以每小时10万单位的速度持续输注。患者在入院后的前72小时以及在接受地尔硫䓬、阿司匹林和经皮硝酸盐口服治疗15天后的24小时内接受心电图监测。在住院早期和15天后，接受延长SK输注治疗的患者室性早搏（PVC）和室性心动过速发作（VT）显著减少。室性心律失常在不稳定型心绞痛中很常见；它们与冠心病的严重程度和心室功能均无关；在肝素、地尔硫䓬和硝酸盐基础上延长SK输注似乎可减少室性心律失常的数量和严重程度。
