Blunda M, Meister S G, Shechter J A, Pickering N J, Wolf N M
Cathet Cardiovasc Diagn. 1984;10(4):319-27. doi: 10.1002/ccd.1810100403.
In order to compare the thrombolytic efficacy of selective versus systemic administration of streptokinase, we gave this drug by either the intracoronary or intravenous routes to 25 patients during the first 6 hours of acute myocardial infarction. All patients had total occlusion of the infarct-related vessel, unresponsive to intracoronary nitroglycerin. Twelve patients received intravenous streptokinase and 13 received intracoronary administration of the drug. Angiograms were taken prior to and during streptokinase administration. Reopening was achieved in 11 of 13 intracoronary patients and 8 of 12 intravenous patients (P = Ns). Time to reopening was longer (54 minutes) in the intravenous patients than in the intracoronary patients (26 minutes) (P less than 0.05). In this study, intravenous streptokinase reopened infarct-related vessels nearly as often as intracoronary streptokinase, but it took longer. Given the limited access and time to prepare for intracoronary infusion and the ease of intravenous administration, further study of intravenous streptokinase is justified.
为比较链激酶选择性给药与全身给药的溶栓效果，我们在急性心肌梗死的最初6小时内，通过冠状动脉内或静脉途径将此药给予25例患者。所有患者梗死相关血管完全闭塞，对冠状动脉内硝酸甘油无反应。12例患者接受静脉链激酶治疗，13例接受冠状动脉内给药。在链激酶给药前及给药期间进行血管造影。冠状动脉内给药的13例患者中有11例血管再通，静脉给药的12例患者中有8例血管再通（P=无显著性差异）。静脉给药患者血管再通时间（54分钟）比冠状动脉内给药患者（26分钟）长（P<0.05）。在本研究中，静脉链激酶使梗死相关血管再通的频率与冠状动脉内链激酶相近，但所需时间更长。鉴于冠状动脉内输注的途径有限且准备时间较长，以及静脉给药的简便性，对静脉链激酶进行进一步研究是合理的。
