Hillis L D, Borer J, Braunwald E, Chesebro J H, Cohen L S, Dalen J, Dodge H T, Francis C K, Knatterud G, Ludbrook P
J Am Coll Cardiol. 1985 Nov;6(5):957-62. doi: 10.1016/s0735-1097(85)80294-1.
To assess the efficacy of intravenous streptokinase in patients with acute myocardial infarction, 40 patients (30 men and 10 women, mean age 54 years) with acute myocardial infarction were given 1.5 million U of streptokinase intravenously in 1 hour, and coronary arteriography was performed repeatedly to assess reperfusion. Streptokinase treatment was begun 270 +/- 86 (mean +/- SD) minutes after the onset of chest pain. Of the 40 patients, 34 had total or near total coronary occlusion before streptokinase administration. In 14 (41%) of these 34 patients, some reperfusion occurred during the 90 minutes after the administration of streptokinase, but in only 11 of the 14 was reperfusion present at 90 minutes. After streptokinase administration, all patients received heparin for 8 to 10 days; they were subsequently administered aspirin and dipyridamole. Clinical evidence of reocclusion during the first 24 hours of heparin therapy occurred in one patient. Thus, when given to patients with acute myocardial infarction and total coronary occlusion an average of 4 1/2 hours after the onset of chest pain, high dose intravenous streptokinase achieves reperfusion in only about 40% and results in sustained reperfusion in only about 30%.
为评估静脉注射链激酶对急性心肌梗死患者的疗效，40例急性心肌梗死患者（30例男性，10例女性，平均年龄54岁）在1小时内静脉注射150万单位链激酶，并反复进行冠状动脉造影以评估再灌注情况。链激酶治疗在胸痛发作后270±86（平均±标准差）分钟开始。40例患者中，34例在注射链激酶前存在完全或近乎完全的冠状动脉闭塞。在这34例患者中的14例（41%），在注射链激酶后的90分钟内出现了一些再灌注，但在这14例中只有11例在90分钟时存在再灌注。注射链激酶后，所有患者接受肝素治疗8至10天；随后给予阿司匹林和双嘧达莫。肝素治疗的头24小时内有1例患者出现再闭塞的临床证据。因此，当在胸痛发作后平均4个半小时给予急性心肌梗死且冠状动脉完全闭塞的患者高剂量静脉注射链激酶时，仅约40%的患者实现再灌注，且仅约30%的患者实现持续再灌注。
