Leisch F, Schützenberger W, Kerschner K, Harringer W, Hofmann R, Herbinger W
Wien Med Wochenschr. 1987 Jun 15;137(10-11):224-9.
124 patients with evolving acute myocardial infarction received high-dose intravenous streptokinase (1.5 Mio U within 60 min i.v.). Hospital mortality was 4% and 11% of the patients suffered from a streptokinase-related complication (most frequent bleeding problems). All complications could be treated medically. The angiographic control in 111 patients (90%) after a mean of 11 +/- 8 days after thrombolysis demonstrated a patent antegrade perfused infarct-artery in 85 patients (77%). From the first 55 patients only 16% had a revascularization procedure. An early revascularization in 39 patients (57%) of the last 69 patients reduced the reinfarction rate from 15 to 7%. The hospital mortality was not influenced (3.6 vs 4.3%). High-dose i.v. streptokinase-application is associated with low treatable complication rates and clinically relevant reperfusion rates. An early revascularization (coronary angioplasty, bypass-surgery) reduces the reinfarction rate to about 50% and improves left ventricular function.
124例急性心肌梗死进展期患者接受了大剂量静脉注射链激酶治疗（60分钟内静脉注射150万单位）。医院死亡率为4%，11%的患者出现链激酶相关并发症（最常见的是出血问题）。所有并发症均可通过药物治疗。111例患者（90%）在溶栓后平均11±8天进行的血管造影检查显示，85例患者（77%）梗死相关动脉前向血流灌注通畅。在前55例患者中，只有16%接受了血运重建手术。在最后69例患者中的39例（57%）进行早期血运重建，使再梗死率从15%降至7%。医院死亡率未受影响（3.6%对4.3%）。大剂量静脉注射链激酶治疗的并发症发生率较低且可治疗，临床再灌注率相关。早期血运重建（冠状动脉成形术、搭桥手术）可将再梗死率降低至约50%，并改善左心室功能。
