Brochier M L
Ann Cardiol Angeiol (Paris). 1985 Mar;34(3):119-24.
Numerous data and controversies have arisen from studies concerning thrombolysis in acute myocardial infarction over the past five years. It is known that coronary artery obstruction is present in approximately 90 percent of acute infarctions during the first 4 hours of onset. Spontaneous renewed flow is noted in 30 percent of cases following the 12th hour, and in 50 percent of cases following the 3rd week. It is possible to obtain early renewed flow in 85 percent of cases with the administration of intracoronary streptokinase, and in 55 to 70 percent of cases with parenteral administration of streptokinase or urokinase. Controversy centers around the effectiveness of thrombolysis in limiting the size of the infarction, thus preserving cardiac function. Due to the numerous different protocols used and the insufficient number of cases reported in randomized studies, it is not possible to determine the superiority of one technique over another in preserving ischemic myocardium. After taking into account the technical constraints of the procedure and the contradictory published results, therapeutic fibrinolysis should remain a research modality as long as its effectiveness in preserving ischemic myocardium has not been established.
在过去五年中，关于急性心肌梗死溶栓治疗的研究产生了大量数据和争议。众所周知，在急性心肌梗死发病的最初4小时内，约90%的病例存在冠状动脉阻塞。在发病12小时后，30%的病例出现自发再通；在发病第3周后，50%的病例出现自发再通。冠状动脉内注射链激酶可使85%的病例早期再通，静脉注射链激酶或尿激酶可使55%至70%的病例早期再通。争议集中在溶栓治疗在限制梗死面积从而保护心脏功能方面的有效性。由于使用的方案众多，且随机研究报告的病例数量不足，因此无法确定一种技术在保护缺血心肌方面优于另一种技术。考虑到该操作的技术限制以及已发表的相互矛盾的结果，只要其在保护缺血心肌方面的有效性尚未确立，治疗性纤溶仍应作为一种研究方式。
