Kennedy J W, Ritchie J L, Davis K B, Fritz J K
N Engl J Med. 1983 Dec 15;309(24):1477-82. doi: 10.1056/NEJM198312153092402.
Two hundred fifty patients were enrolled in a multicenter, community-based study of the efficacy of intracoronary streptokinase thrombolysis in acute myocardial infarction; 134 were randomly assigned to streptokinase therapy and 116 were controls. All patients underwent left ventricular angiography and coronary arteriography before the random assignment. The mean time from the onset of symptoms to hospitalization was 134 +/- 144 minutes (S.D), and the mean time to random assignment was 276 +/- 185 minutes. Coronary reperfusion was achieved in 68 per cent of the streptokinase-treated group. The overall 30-day mortality was 18 (7.2 per cent); there were five deaths in the streptokinase-treated group (3.7 per cent) and 13 in the control group (11.2 per cent, P less than 0.02). Fifteen of the 18 deaths occurred in patients with anterior infarction. Intracoronary streptokinase therapy resulted in a nearly threefold reduction in the 30-day mortality after hospitalization for acute myocardial infarction.
250名患者参与了一项基于社区的多中心研究，以评估冠状动脉内链激酶溶栓治疗急性心肌梗死的疗效；134名患者被随机分配接受链激酶治疗，116名作为对照。所有患者在随机分组前均接受了左心室血管造影和冠状动脉造影。症状出现至住院的平均时间为134±144分钟（标准差），随机分组的平均时间为276±185分钟。链激酶治疗组68%实现了冠状动脉再灌注。30天总死亡率为18例（7.2%）；链激酶治疗组有5例死亡（3.7%），对照组有13例死亡（11.2%，P<0.02）。18例死亡中有15例发生在前壁梗死患者中。冠状动脉内链激酶治疗使急性心肌梗死后住院30天死亡率降低了近三倍。
