Helft G, Lebrazi J, Elalamy I, Beygui F, Le Feuvre C, Metzger J P, Vacheron A, Samama M M
Clinique Cardiologique, Hôpital Necker, Paris.
Ann Cardiol Angeiol (Paris). 1998 Oct;47(8):582-8.
Myocardial infarction is due to thrombotic occlusion of a coronary artery. Current thrombolytic agents have demonstrated their major value by inducing a significant reduction of mortality, but they nevertheless present certain limits: 1) excellent arterial patency is obtained in only about 50% of cases; 2) reocclusions persist in 5 to 10% of cases; 3) very severe complications, such as cerebral haemorrhages, have not disappeared (about 0.5% of cases). There is therefore a large field of action for development of the optimal thrombolytic agent. Research concerning staphylokinase, classified among third generation thrombolytic agents, is therefore situated in this context. Staphylokinase is a protein known to possess profibrinolytic properties for more than four decades, but has been the subject of renewed interest over recent years. This article reviews the characteristics, mechanism of action and fibrinolytic properties of staphylokinase. It recalls the main results obtained in animal models and summarizes the main clinical trials in man.
心肌梗死是由冠状动脉血栓形成性闭塞所致。目前的溶栓药物已通过显著降低死亡率证明了其主要价值,但它们仍存在一定局限性:1)仅约50%的病例能实现良好的动脉通畅;2)5%至10%的病例会持续出现再闭塞;3)非常严重的并发症,如脑出血,并未消失(约0.5%的病例)。因此,开发最佳溶栓药物有很大的作用空间。关于葡萄球菌激酶(归类于第三代溶栓药物)的研究正是在这一背景下开展的。葡萄球菌激酶是一种已知具有促纤溶特性超过四十年的蛋白质,但近年来再度引起了人们的关注。本文综述了葡萄球菌激酶的特性、作用机制和纤溶特性。回顾了在动物模型中获得的主要结果,并总结了在人体进行的主要临床试验。