Maroko P R, Hillis L D, Muller J E, Tavazzi L, Heyndrickx G R, Ray M, Chiariello M, Distante A, Askenazi J, Salerno J, Carpentier J, Reshetnaya N I, Radvany P, Libby P, Raabe D S, Chazov E I, Bobba P, Braunwald E
N Engl J Med. 1977 Apr 21;296(16):898-903. doi: 10.1056/NEJM197704212961603.
To evaluate hyaluronidase's effect in reducing post-infarction myocardial necrosis, we randomized 91 patients with anterior infarction to control (45) or to hyaluronidase-treatment (46) groups. A 35-lead precordial electrocardiogram was recorded on admission and seven days later. Hyaluronidase was administered intravenously after the first electrocardiogram and every six hours for 48 hours. QRS-complex changes were analyzed to assess the drug's effect. Precordial sites with ST-segment elevation (larger than or equal to 0.15 mV) on the initial electrocardiogram that retained an R wave were considered vulnerable for the development of electrocardiographic signs of necrosis. The sum of R-wave voltages of vulnerable sites fell more in the control group than in the hyaluronidase group (70.9 +/- 3.6 per cent [+/- 1 S.E.M.] vs 54.2 +/- 5.0 per cent P less than 0.01). Q waves appeared in 59.3 +/- 4.9 per cent of the vulnerable sites in control versus 46.4 +/- 4.9 per cent in hyaluronidase-treated patients (P less than 0.05). Thus, hyaluronidase reduced the frequency of electrocardiographic signs of myocardial necrosis.
为评估透明质酸酶在减少心肌梗死后心肌坏死方面的作用，我们将91例前壁心肌梗死患者随机分为对照组（45例）和透明质酸酶治疗组（46例）。入院时及7天后记录35导联胸前心电图。在首次心电图检查后静脉注射透明质酸酶，每6小时注射1次，共注射48小时。分析QRS波群变化以评估药物疗效。初始心电图上ST段抬高（大于或等于0.15mV）且仍有R波的胸前部位被认为易出现坏死的心电图征象。对照组中易损部位R波电压总和下降幅度大于透明质酸酶治疗组（分别为70.9±3.6%[±1标准误]和54.2±5.0%，P<0.01）。对照组中59.3±4.9%的易损部位出现Q波，而透明质酸酶治疗组患者为46.4±4.9%（P<0.05）。因此，透明质酸酶降低了心肌坏死心电图征象的发生率。
