Lo Y S
Clin Cardiol. 1985 Dec;8(12):609-19. doi: 10.1002/clc.4960081202.
Nine studies specifically dealing with the comparison of intravenous streptokinase (IVSK) and intracoronary streptokinase (ICSK) in the treatment of acute myocardial infarction (MI) were analyzed to determine if IVSK is as efficacious as ICSK in achieving thrombolysis. Pooled data from the studies yielded success rates of 73% for IVSK and 72% for ICSK. Considering that the studies which did not perform preintervention angiogram may have overestimated the thrombolytic success rate in IVSK patients, there is a possibility that ICSK may be slightly more effective in achieving acute reperfusion. Bleeding complications were similar, and a systemic lytic state was observed in both treatment groups. No definitive conclusions can be drawn regarding the differences between groups in improvements of left ventricular function and mortality rates. ICSK has the advantage of direct documentation of reperfusion and spares the patient the risk of anticoagulation should the attempt fail. On the other hand, IVSK is cheaper, easier to administer, and can logistically be given earlier (even in the emergency room or ambulance) than ICSK; it is therefore more widely available, and may be the preferred mode of treatment in community hospitals where cardiac catheterization facilities are not readily available, if streptokinase is to be given at all.
对九项专门比较静脉注射链激酶（IVSK）和冠状动脉内链激酶（ICSK）治疗急性心肌梗死（MI）疗效的研究进行了分析，以确定IVSK在实现溶栓方面是否与ICSK一样有效。这些研究的汇总数据显示，IVSK的成功率为73%，ICSK的成功率为72%。鉴于未进行干预前血管造影的研究可能高估了IVSK患者的溶栓成功率，ICSK在实现急性再灌注方面可能略更有效。出血并发症相似，两个治疗组均观察到全身溶解状态。关于两组在左心室功能改善和死亡率方面的差异，无法得出明确结论。ICSK的优点是可直接记录再灌注情况，且如果尝试失败，可使患者避免抗凝风险。另一方面，IVSK更便宜、更易于给药，并且在后勤方面比ICSK更早给予（甚至在急诊室或救护车上）；因此它更广泛可用，如果要使用链激酶，在没有心脏导管插入设施的社区医院中，IVSK可能是首选的治疗方式。
