Trask J L, Trask N W, Cushing W J, Butler H E, Usher B W
J S C Med Assoc. 1989 Nov;85(11):503-6.
Streptokinase can dramatically impact upon management of myocardial infarctions in community hospitals. When given by experienced personnel during the first six hours after onset of symptoms, streptokinase is associated with a high patency rate, improved left ventricular function, and reduced mortality. Careful screening of patients results in a low complication rate with infrequent serious bleeding. Streptokinase should be utilized in those hospitals without cardiac catheterization facilities, but in light of the relatively high incidence of recurrent pain (15.8%), transfer of stable patients to a facility with a catheterization laboratory should be carried out within 24 to 72 hours. As approximately 60% of patients will require PTCA, CABG, or both, diagnostic cardiac catheterization should be considered in all patients unless there are other mitigating factors.
链激酶可显著影响社区医院对心肌梗死的治疗。由经验丰富的人员在症状出现后的头六个小时内给药时，链激酶与高血管通畅率、改善左心室功能及降低死亡率相关。对患者进行仔细筛查可使并发症发生率较低，严重出血情况罕见。在没有心脏导管插入设备的医院应使用链激酶，但鉴于复发性疼痛的发生率相对较高（15.8%），应在24至72小时内将病情稳定的患者转至有导管插入实验室的机构。由于约60%的患者需要进行经皮冠状动脉腔内血管成形术（PTCA）、冠状动脉旁路移植术（CABG）或两者都需要，除非有其他缓解因素，所有患者均应考虑进行诊断性心脏导管插入术。
