Lupínek Z, Janousek S, Lupínková Z, Meluzín J, Novák M, Soucek M, Rysavý F
I. interní klinika FN, Brno.
Vnitr Lek. 1991 Jan;37(1):21-8.
In 314 patients with a first myocardial infarction, admitted within four hours after development of symptoms, the authors used in addition to standard therapy heparin treatment in 205 and streptokinase treatment (1.5 mil. u. i.v. with subsequent i.v. heparin administration) in 109 patients. Thrombolytic treatment was more effective, it reduced the lethality by 55.7% and was associated with a lower incidence of complications during the first 30 days. The reduced lethality, however, did not reach statistical significance because of the small number of patients and the low mortality rate in both groups. The left ventricular ejection fraction was practically equal in both groups after six weeks. Undesirable effects of thrombolytic therapy were rare and did not seriously threaten the patients. Provided contraindications are carefully respected, this treatment is safe and its routine use in the treatment of new myocardial infarctions must be supported. Streptokinase remains the drug of choice because it is equally effective as other available fibrinolytics and is the cheapest one.
在314例首次发生心肌梗死且症状出现后4小时内入院的患者中，作者除了对205例患者采用标准治疗外还加用了肝素治疗，对109例患者采用了链激酶治疗（静脉注射150万单位，随后静脉注射肝素）。溶栓治疗更有效，它使死亡率降低了55.7%，并且与最初30天内较低的并发症发生率相关。然而，由于两组患者数量少且死亡率低，死亡率的降低未达到统计学显著性。六周后两组的左心室射血分数实际相等。溶栓治疗的不良影响很少，并未严重威胁患者。只要严格遵守禁忌证，这种治疗是安全的，其在新发生心肌梗死治疗中的常规应用必须得到支持。链激酶仍然是首选药物，因为它与其他可用的纤维蛋白溶解剂效果相同且是最便宜的一种。
