Duraković Z, Smalcelj A, Radonić R, Ivanović D, Gasparović V, Gjurasin M, Bosnić D, Ljubojević B, Bogdan I, Grgić V
Iz Klinike za unutrasnje bolesti s poliklinikom Medicinskog fakulteta Sveucilista i Klinickog bolnickog centra u Zagrebu.
Acta Med Iugosl. 1990;44(3):185-96.
During 2 years and 3 months 230 patients suffering from acute myocardial infarction were treated at an Intensive Care Unit and a Department of Cardiology. Streptokinase was given intravenously to 54 of them. Out of 54 patients, in 52% the localisation of the myocardial infarction was in the anterior and in 48% in the posterior wall. The patients were divided in the three categories according to the onset of symptoms: up to 2 hours, 2-4 hours and 4-6 hours. The dose of streptokinase was 1,500,000 i.u. during 1.5 hours. The CPK and MBCPK level reached the maximum values up to 12 hours and was to lowest in the first group. In 74% of the patients the serum enzyme level showed successful reperfusion of a coronary artery. Electrocardiographic findings of a successful myocardial reperfusion amounted to 36% in the first, 40% in the second, and 17% in the third group. Malignant ventricular arrhythmias appeared in the first group in 3.6%, in the second in 12.5% and in the third group in 14.2%. The criteria for successful myocardial reperfusion by echocardiography (analysed regional wall motion) were present in 52% in the first, in 50% in the second, and in 17% in the third group. Coronarography and ventriculography were performed in 17 patients after 21 days of treatment, with successful results in 88% (15 out of 17 patients). In a group of 176 patients unable to be treated with streptokinase because of the onset of symptoms of myocardial infarction (more than 6 hours) or because of contraindications for that treatment, the lethality rate reached 17.6%. The lethality rate in the group of 54 patients treated with streptokinase was 5.5%. Local complication (hemorrhage) during the treatment was observed in one patient (2%).
在2年零3个月的时间里，230名急性心肌梗死患者在重症监护病房和心脏病科接受了治疗。其中54名患者接受了静脉注射链激酶治疗。在这54名患者中，52%的心肌梗死部位在前壁，48%在后壁。根据症状发作时间，患者被分为三类：症状发作后2小时内、2 - 4小时和4 - 6小时。链激酶剂量为150万国际单位，静脉滴注1.5小时。肌酸磷酸激酶（CPK）和肌酸磷酸激酶同工酶（MBCPK）水平在12小时内达到最高值，且在第一组中最低。74%的患者血清酶水平显示冠状动脉成功再灌注。心肌再灌注成功的心电图表现，第一组为36%，第二组为40%，第三组为17%。恶性室性心律失常在第一组中的发生率为3.6%，第二组为12.5%，第三组为14.2%。通过超声心动图（分析局部室壁运动）判断心肌再灌注成功的标准，第一组为52%，第二组为50%，第三组为17%。17名患者在治疗21天后进行了冠状动脉造影和心室造影，17名患者中有15名（88%）结果成功。在一组因心肌梗死症状发作（超过6小时）或因治疗禁忌而无法接受链激酶治疗的176名患者中，死亡率达到17.6%。接受链激酶治疗的54名患者组的死亡率为5.5%。治疗期间观察到1例患者（2%）出现局部并发症（出血）。
