Cowley M J
Circulation. 1983 Aug;68(2 Pt 2):I90-5.
Clinical experience indicates that the methods of intracoronary thrombolysis are not standardized. Although overall reperfusion rates of 75-80% have been achieved, clinical application at individual centers reflects variations in thrombolytic agents used, dosage, infusion rates, technique of administration and use of adjunctive measures, as well as variation in rates of successful recanalization. Analysis of results as a function of differences in approach suggests that certain procedural factors may influence reperfusion rates. Within the range of total dosage and infusion rates used, higher dosage levels and infusion rates appear to be associated with higher rates of reperfusion. Experimental and preliminary clinical results also suggest that subselective infusion may be associated with higher response rates than ostial infusion of thrombolytic agents. However, additional studies are needed to define the optimal methods of intracoronary thrombolytic therapy.
临床经验表明，冠状动脉内溶栓方法并不规范。尽管总体再灌注率已达到75% - 80%，但各中心的临床应用情况显示，在溶栓药物的使用、剂量、输注速率、给药技术及辅助措施的使用方面存在差异，成功再通率也有所不同。根据治疗方法差异对结果进行分析表明，某些操作因素可能会影响再灌注率。在所用总剂量和输注速率范围内，较高的剂量水平和输注速率似乎与更高的再灌注率相关。实验和初步临床结果还表明，与在冠状动脉开口处输注溶栓药物相比，选择性亚组输注可能有更高的反应率。然而，还需要进一步研究来确定冠状动脉内溶栓治疗的最佳方法。
