Fedeli F, Skouse D, Messina A
Divisione di Cardiologia-UCC, Azienda Ospedaliera E. Morelli, Sondalo, Sondrio.
Minerva Cardioangiol. 1997 Jul-Aug;45(7-8):377-81.
A case of an important intracranial hemorrhage after a low dose (approx. 500,000 UI) of streptokinase in a 60 year-old woman suffering from myocardial infarction is presented. Clinical, electrocardiographic, echocardiographic, lab and tomographic findings are described. The authors suggest a pharmacokinetic mechanism which could be responsible of a "paradox effect" (a powerful and dangerous effect of the drug when given in low dose) and they wonder whether in case of allergic reactions should it be better not to stop the infusion of the thrombolytic drug and be more liberal with the "symptomatic" drugs. Tha patient is still alive and the clinical conditions slowly progressing.
本文报道了一例60岁患有心肌梗死的女性在接受低剂量（约500,000国际单位）链激酶治疗后发生重要颅内出血的病例。描述了临床、心电图、超声心动图、实验室及断层扫描检查结果。作者提出了一种药代动力学机制，该机制可能导致“矛盾效应”（药物低剂量使用时产生的强大且危险的效应），他们还探讨了在发生过敏反应时，是否最好不要停止溶栓药物输注，而应更自由地使用“对症”药物。患者仍然存活，临床状况正在缓慢进展。
