Urdahl K B, Mathews J D, Currie B
Department of Microbiology, University of Minnesota Medical School, Minneapolis, USA.
Aust N Z J Med. 1996 Feb;26(1):49-53. doi: 10.1111/j.1445-5994.1996.tb02906.x.
Thrombolytic treatment with streptokinase in acute myocardial infarction has proven to be safe and effective in Caucasian populations with relatively low levels of anti-streptokinase IgG and streptokinase resistance. Higher levels of antibodies, as seen in previous recipients of streptokinase therapy, cause more adverse reactions and may result in lower efficacy.
To examine the levels of anti-streptokinase IgG and streptokinase resistance in a population subjected to endemic streptococcal infections.
Thirty Aboriginal adults from a remote community in Northern Australia with endemic streptococcal infections and 15 non-Aboriginal adults from an urban community without endemic infections participated in this study. Aboriginal adults exhibited levels of anti-streptokinase IgG and streptokinase resistance that, respectively, were almost 20 and 15 times greater than the values of non-Aboriginal adults. At least 23% of Aboriginal adults had sufficiently high levels of streptokinase resistance to neutralise a standard 1.5 million unit dose of streptokinase.
Aboriginal adults from a remote community had dramatically elevated levels of anti-streptokinase IgG and in vitro streptokinase resistance. Prospective studies are needed to assess the clinical relevance of streptokinase resistance in populations from areas with endemic streptococcal infection.
在抗链激酶IgG水平相对较低且对链激酶耐药性较低的白种人群中，急性心肌梗死采用链激酶溶栓治疗已被证明是安全有效的。如先前接受链激酶治疗的患者所见，较高水平的抗体可引起更多不良反应，并可能导致疗效降低。
检测在地方性链球菌感染人群中抗链激酶IgG水平和链激酶耐药性。
来自澳大利亚北部一个偏远社区的30名患有地方性链球菌感染的原住民成年人和15名来自无地方性感染的城市社区的非原住民成年人参与了本研究。原住民成年人的抗链激酶IgG水平和链激酶耐药性分别几乎是非原住民成年人的20倍和15倍。至少23%的原住民成年人具有足够高的链激酶耐药性，可中和标准的150万单位剂量的链激酶。
来自偏远社区的原住民成年人的抗链激酶IgG水平和体外链激酶耐药性显著升高。需要进行前瞻性研究以评估地方性链球菌感染地区人群中链激酶耐药性的临床相关性。
