Kasper W, Meinertz T, Wollschläger H, Bonzel T, Chen C, Hofmann T, Zeiher A, Drexler H, Just H
Klinikum der Albert-Ludwigs-Universität, Med. Universitäts Klinik, Abteilung Innere Medizin III, Kardiologie, Freiburg.
Drugs. 1987;33 Suppl 3:112-6. doi: 10.2165/00003495-198700333-00018.
50 consecutive patients with acute myocardial infarction and symptoms of less than 4 hours duration were treated with anisoylated plasminogen streptokinase activator complex (APSAC) 30U intravenously as a bolus injection over 5 minutes. An open infarct-related artery was found in 32 patients (64%) when the first coronary angiography was taken 66 +/- 21 minutes after APSAC. Complete reperfusion was subsequently seen in 10 of 18 patients with an occluded infarct-related artery 74 +/- 16 minutes after injection of APSAC. Thus, a patient infarct-related artery was seen in 42 patients (84%) within 68 +/- 20 minutes. A control coronary angiography was performed in 37 patients (74%) after 25 +/- 19 days. Reocclusion was found in 5 patients. The minimal cross-sectional area of the residual coronary stenosis increased from 1.3 +/- 0.9 mm2 to 1.8 +/- 1.9 mm2. Patients with residual thrombi after coronary thrombolysis (n = 13) demonstrated an increase of the minimal cross-sectional area of the residual stenosis from 1.2 +/- 0.8 to 2.6 +/- 2.3 mm2, whereas those without residual thrombi showed only minor changes of the minimal cross-sectional area (1.3 +/- 0.9 to 1.2 +/- 1.2 mm2). Thus, APSAC demonstrated a high patency rate and a low reocclusion rate after intravenous administration. The prolonged fibrinolytic activity of APSAC leads to a further regression of the residual coronary stenosis among patients with coronary thrombi after reperfusion.
50例急性心肌梗死且症状持续时间少于4小时的患者接受了静脉注射茴香酰化纤维蛋白溶酶原链激酶激活剂复合物（APSAC）30U的治疗，推注时间为5分钟。在注射APSAC后66±21分钟进行首次冠状动脉造影时，32例患者（64%）发现梗死相关动脉开通。随后，在18例梗死相关动脉闭塞的患者中，有10例在注射APSAC后74±16分钟出现完全再灌注。因此，42例患者（84%）在68±20分钟内梗死相关动脉开通。37例患者（74%）在25±19天后进行了对照冠状动脉造影。发现5例患者出现再闭塞。残余冠状动脉狭窄的最小横截面积从1.3±0.9mm²增加到1.8±1.9mm²。冠状动脉溶栓后有残余血栓的患者（n = 13），残余狭窄的最小横截面积从1.2±0.8增加到2.6±2.3mm²，而无残余血栓的患者残余狭窄的最小横截面积仅出现轻微变化（1.3±0.9到1.2±1.2mm²）。因此，APSAC静脉给药后显示出高开通率和低再闭塞率。APSAC延长的纤溶活性导致再灌注后冠状动脉血栓患者残余冠状动脉狭窄进一步减轻。
