Jackson D
Beecham Pharmaceuticals Research Division, Brockham Park, Betchworth.
Drugs. 1987;33 Suppl 3:104-11. doi: 10.2165/00003495-198700333-00017.
Preliminary investigations using a single intracoronary dose of APSAC (up to 30U) revealed dissolution of intracoronary thrombi in 59 of 83 patients (71%) with acute myocardial infarction, as indicated by reperfusion of coronary arteries. Reocclusion of arteries occurred in 20.5% of patients. Based on these findings, a subsequent study was undertaken in 302 patients with evidence of recent acute myocardial infarction. Single intravenous bolus doses of APSAC (5 to 30U) produced reperfusion in 79% of patients, with reocclusion occurring in only 9% of patients receiving the higher doses. Adverse effects included an initial hypotension/bradycardia reaction, a later syndrome featuring pyrexia, nausea and vomiting, and bleeding complications, including 4 patients with cerebrovascular accidents. In these early studies APSAC appeared to be as effective as streptokinase, as reported in the literature, and to produce a lower incidence of reocclusion than tissue plasminogen activator.
使用单次冠状动脉内注射氨甲环酸纤溶酶原激活剂（APSAC，剂量高达30单位）的初步研究显示，83例急性心肌梗死患者中有59例（71%）冠状动脉内血栓溶解，表现为冠状动脉再灌注。20.5%的患者动脉再次闭塞。基于这些发现，对302例近期有急性心肌梗死证据的患者进行了后续研究。单次静脉推注APSAC（5至30单位）使79%的患者实现再灌注，接受较高剂量的患者中只有9%出现再闭塞。不良反应包括最初的低血压/心动过缓反应、后期以发热、恶心和呕吐为特征的综合征以及出血并发症，包括4例脑血管意外患者。在这些早期研究中，APSAC似乎与文献报道的链激酶一样有效，并且与组织型纤溶酶原激活剂相比，再闭塞发生率更低。
