Aninat M, Col J J, Rankin J, Jacquet L, Anwar A, Etienne J
Departamento de Medicina Intensiva, Hospital Universitario San Lucas, Universidad de Lovaina, Bruselas, Belgica.
Rev Med Chil. 1990 Aug;118(8):862-7.
Most reports concerning the use of streptokinase (SK) for thrombolysis in myocardial infarction (MI) have employed doses over 1,000,000 units. We evaluated the efficacy of a dose of 500,000 U in 40 patients with acute MI who received full heparin dose before, during and after SK. Thrombolytic effect, as measured by the protamine neutralized thrombin time was shown to be strong in 60% of cases, moderate in 17% and weak in 22%, and this was not modified by larger SK doses. A patent culprit artery was demonstrated at coronary arteriography performed 3 days after SK in 90% of patients. Only one instance of severe bleeding was observed. Thus, a reduced SK dose in association to heparin provides adequate lytic effect and artery patency rate in patients with MI.
大多数关于在心肌梗死（MI）中使用链激酶（SK）进行溶栓治疗的报告所采用的剂量超过100万单位。我们评估了50万单位剂量的SK对40例急性MI患者的疗效，这些患者在SK治疗前、治疗期间及治疗后均接受了全剂量肝素治疗。通过鱼精蛋白中和凝血酶时间测定的溶栓效果显示，60%的病例效果强烈，17%的病例效果中等，22%的病例效果较弱，且更大剂量的SK并未改变这种情况。在SK治疗3天后进行的冠状动脉造影显示，90%的患者梗死相关动脉通畅。仅观察到1例严重出血情况。因此，与肝素联合使用时减少SK剂量可为MI患者提供足够的溶栓效果和动脉通畅率。
