Hishamuddin H M, Azmi N N, Jackson N
Department of Medicine, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan.
Singapore Med J. 1993 Aug;34(4):316-8.
Thrombolytic therapy is a well-established therapy in acute myocardial infarction (AMI), reducing mortality and infarct size. This study is a retrospective analysis of survival and complications after the use of streptokinase at Hospital Universiti Sains Malaysia. Streptokinase was first used here in March 1990. Between then and February 1992, 126 patients were admitted to the Coronary Care Unit. Thirty-two patients who fulfilled our criteria for thrombolytic treatment were given an hour intravenous infusion of 1.5 MU streptokinase, and started on aspirin. A control group of 64 patients selected from before March 1990, and matched for age, sex and site of infarct, was given standard therapy. The survival at 4 weeks post-AMI was 91% in the streptokinase therapy group and 91% in both groups (p > 0.05). The complications encountered were reperfusion arrhythmias (2 patients), hypotension(1), maculopapular rash(1) and gum bleeding(1). None of these complications were statistically increased when compared to the control group and none resulted in the death of a patient. We conclude that streptokinase therapy can be given safely in a rural Malaysian setting. Our survival and complication rates are comparable with other published series.
溶栓治疗是急性心肌梗死（AMI）中一种成熟的治疗方法，可降低死亡率和梗死面积。本研究是对马来西亚理科大学医院使用链激酶后的生存率和并发症进行的回顾性分析。链激酶于1990年3月首次在此使用。从那时起到1992年2月，有126名患者被收治入冠心病监护病房。32名符合我们溶栓治疗标准的患者接受了1.5 MU链激酶1小时静脉输注，并开始服用阿司匹林。从1990年3月之前选取64名年龄、性别和梗死部位相匹配的患者作为对照组，给予标准治疗。AMI后4周时，链激酶治疗组的生存率为91%，两组均为91%（p>0.05）。出现的并发症有再灌注心律失常（2例）、低血压（1例）、斑丘疹（1例）和牙龈出血（1例）。与对照组相比，这些并发症在统计学上均未增加，且无一例导致患者死亡。我们得出结论，在马来西亚农村地区可以安全地使用链激酶治疗。我们的生存率和并发症发生率与其他已发表的系列研究相当。
