Schröder R, Biamino G, von Leitner E R, Linderer T
Dtsch Med Wochenschr. 1981 Mar 6;106(10):294-301. doi: 10.1055/s-2008-1070305.
Intravenous treatment over 30 minutes with 500 000 U streptokinase was given to 21 patients with acute myocardial infarction. Serial measurements of serum CK-MB activity made recanalisation of the infarcted artery likely in 3 patients. Selective coronarography was performed in 18 patients during the acute infarction phase. Angiographic follow-up investigations were done 24 hours and after 3 weeks. In 3 cases only subtotal occlusion of the infarcted coronary artery was seen during the acute phase. A thrombus demonstrated in two patients could be lysed. In 8 out of 15 patients with complete coronary artery occlusion the infarcted vessel was reopened 20-60 minutes after onset of intravenous streptokinase infusion. In a further 4 patients recanalisation was observed 60-140 minutes after passing a guide wire or during an additional intracoronary infusion of streptokinase. The infarcted vessel remained occluded in 3 patients, one of whom died following myocardial rupture. In 12 patients with recanalisation of the infarcted artery during the acute phase a premature maximum of serial CK-MB serum activity was seen after 13.5 +/- 2.9 hours in comparison with 20.9 +/- 5.3 hours in 122 patients treated conventionally. Serial enzyme determinations allow indirect conclusions as to a rapid recanalisation of an infarcted blood vessel.
对21例急性心肌梗死患者进行了30分钟的静脉注射500000 U链激酶治疗。对血清CK-MB活性进行系列测量显示，3例患者梗死动脉可能再通。18例患者在急性梗死期进行了选择性冠状动脉造影。在24小时及3周后进行了血管造影随访检查。在急性期，仅3例患者可见梗死冠状动脉次全闭塞。两名患者显示的血栓得以溶解。15例冠状动脉完全闭塞的患者中，8例在静脉注射链激酶开始后20 - 60分钟梗死血管重新开放。另外4例患者在通过导丝后60 - 140分钟或在冠状动脉内额外注射链激酶期间观察到再通。3例患者梗死血管仍闭塞，其中1例因心肌破裂死亡。12例在急性期梗死动脉再通的患者，系列CK-MB血清活性在13.5±2.9小时后出现过早峰值，而122例接受传统治疗的患者为20.9±5.3小时。系列酶测定可间接推断梗死血管的快速再通情况。
