Natarajan D, Rai V N, Jain A, Roy T, Sharma P K, Nigam P D
Department of Cardiology, Dr. Ram Manohar Lohia Hospital, New Delhi, India.
Int J Cardiol. 1988 May;19(2):181-9. doi: 10.1016/0167-5273(88)90078-2.
To assess the relative efficacy of coronary thrombolysis using intracoronary versus intravenous streptokinase, 32 patients with acute myocardial infarction were randomly assigned to receive intracoronary (n = 17) and intravenous streptokinase (n = 15). All patients underwent selective coronary arteriography before and after administration of streptokinase by either route within 4 hours of the onset of symptoms. Intravenous streptokinase was given as 750,000 units over 30 minutes, while a mean dose of 180,000 units was required for thrombolysis in the group having intracoronary delivery. Recanalization occurred in 71.4% (10 of 14) of patients receiving streptokinase, by the intracoronary group in contrast to only 25% of patients (3 of 12) who received the drug intravenously (P less than 0.05). Spontaneous thrombolysis was seen in 17.6% and 20% of the patients in the groups having intracoronary and intravenous delivery, respectively. Bleeding complications were few in both groups. Thus, when baseline coronary arteriography is performed, recanalization with intracoronary streptokinase is more effective in the treatment of acute myocardial infarction than intravenous streptokinase.
为评估冠状动脉内注射与静脉注射链激酶进行冠状动脉溶栓的相对疗效，32例急性心肌梗死患者被随机分为两组，分别接受冠状动脉内注射链激酶（n = 17）和静脉注射链激酶（n = 15）。所有患者在症状发作4小时内通过任一途径给予链激酶前后均接受了选择性冠状动脉造影。静脉注射链激酶的剂量为30分钟内给予750,000单位，而冠状动脉内给药组溶栓平均需要180,000单位。冠状动脉内注射链激酶组接受链激酶治疗的患者中71.4%（14例中的10例）实现了再通，相比之下，静脉注射链激酶组仅25%（12例中的3例）的患者实现再通（P小于0.05）。冠状动脉内给药组和静脉给药组分别有17.6%和20%的患者出现自发溶栓。两组出血并发症均较少。因此，在进行基线冠状动脉造影时，冠状动脉内注射链激酶治疗急性心肌梗死比静脉注射链激酶更有效。
