目的 观察链激酶(SK)静脉滴注加速溶栓治疗急性心肌梗死(AMI)的疗效及安全性。方法 120例AMI患者接受SK 静脉滴注加速溶栓治疗,于30 min静脉滴注SK150万U,120例患者随机分为地塞米松组及对照组(各60例),地塞米松组患者溶栓前静注地塞米松2～5 mg。结果 ①血管再通率为75.0%,5周病死率为5.0%,出血发生率为8.3%,溶栓距发病时间≤6 h血管再通率明显高于>6 h血管再通率(P<0.01)。②应用地塞米松组与未用地塞米松组过敏反应的发生率相似(P>0.05)。③≤65岁患者的血管再通率与不良反应发生率与>65岁组无显著性差异(P>0.05);再灌注心律失常发生率为 38.3%。结论 ①SK静脉滴注加速溶栓治疗急性心肌梗死安全、有效,适于国人使用;宜提倡院前和急诊室溶栓。②地塞米松是否能预防SK所致过敏反应无明确结论,需进一步观察。③>65岁患者行静脉滴注加速溶栓治疗是安全可行的,但要视每位患者的具体情况而定。

OBJECTIVE To observe the therapeutic effect and safety of brief-duration intravenous infusion of SK in patients with AMI. METHODS One hundred and twenty patients with AMI were treated by brief-duration intravenous infusion of SK(BEHRING),1.5 million units within 30 minutes.All patients were divided into two groups randomly.One group were given dexamethasone 2～5 mg and the other group were not. RESULTS ①The reperfusion rate was 75.0% and the total 5-week mortality rate was 5.0%.The rate of bleeding was 8.3%.The reperfusion rate of the patients who received thrombolysis less than 6 hours after the onset of symptoms was much higher than that of more than 6 hours (P＜0.01).②The rate of occurrence of allergic reactions revealed no significant differences between the two groups(P＞0.05).③There were also no significant differences in the reperfusion rate and the rate of occurrence of side effects between ≤65yrs group and ＞65 yrs group(P＞0.05).The rate of reperfusion arrhythmia was 38.3%.CONCLUSIONS①Brief-duration intravenous infusion of SK in patients with AMI appearetd to be safe and effective,and suitable to Chinese.It is necessary to advocate prehospital thrombolysis while transporting to hospital or in emergency room.②There is no clear conclusion wether dexamethasone may prevent allergic reactions caused by SK.③It is safe to administer intravenous infusion of SK to patients who are over 65 yrs old,but the patients’general conditions should be considered carefully.