Brewer C C, Markis J E
Heart Lung. 1986 Nov;15(6):552-8.
The use of thrombolytic agents for the treatment of myocardial infarction is increasing. Many community hospitals are infusing SK intravenously and those with cardiac catheterization laboratories often use intracoronary SK and angioplasty. Tissue plasminogen activator is undergoing extensive clinical trials, and reports of this research should add to our knowledge of this new therapy. Recently, benefits from thrombolytic therapy such as increased ejection fraction, improved regional wall motion, and short-term decreases in mortality have been documented. Both the GISSI trial that recruited 11,712 patients in Italy and the Netherlands trial documented significant short-term decreases in mortality after therapy with SK compared with control groups. As this information reaches the medical community, we may see an increase in the use of thrombolytic therapy during acute myocardial infarction. Additionally, community education service organizations should reemphasize the importance of seeking help early after the signs and symptoms of acute myocardial infarction appear to promote early treatment and potential salvage of greater amounts of myocardium. The long-term prognosis of patients who have been successfully reperfused and the best management after thrombolytic therapy is not yet known. Future problems and benefits from this therapy are still to be determined.
溶栓药物用于治疗心肌梗死的情况正在增加。许多社区医院正在静脉输注链激酶，而那些设有心导管实验室的医院则经常使用冠状动脉内链激酶和血管成形术。组织型纤溶酶原激活剂正在进行广泛的临床试验，这项研究的报告应会增加我们对这种新疗法的了解。最近，溶栓治疗的益处，如射血分数增加、局部室壁运动改善以及死亡率短期下降，已得到证实。在意大利招募了11712名患者的GISSI试验和荷兰试验均表明，与对照组相比，链激酶治疗后死亡率有显著短期下降。随着这一信息传达至医学界，我们可能会看到急性心肌梗死期间溶栓治疗的使用增加。此外，社区教育服务组织应再次强调在急性心肌梗死症状和体征出现后尽早寻求帮助的重要性，以促进早期治疗并可能挽救更多的心肌。成功再灌注患者的长期预后以及溶栓治疗后的最佳管理尚不清楚。这种疗法未来的问题和益处仍有待确定。
