ObjectiveTo systematically review the effectiveness and safety of thrombolytics for treating ST-segment elevation myocardial infarction (STEMI) in China by network meta-analysis.MethodsThe PubMed, EMbase, The Cochrane Library, Web of Science, CBM, WanFang Data, and CNKI databases were searched for randomized controlled trials (RCTs) of thrombolytics for Chinese patients with STEMI from inception to October 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Statistical analysis was performed by WinBUGS 1.4.3 software and R 3.3.1 software.ResultsA total of 32 RCTs involving 3 164 patients with 7 types of thrombolytics were included. The results of network meta-analysis showed: the urokinase had lower reperfusion rate than tenecteplase (rhTNK-tPA), reteplase, alteplase, and pro-urokinase (all P values <0.05), however, had higher mortality or major adverse cardiovascular events rates than rhTNK-tPA, reteplase, alteplase, and pro-urokinase (all P values <0.05), and higher incidence of non-intracranial hemorrhage than those of alteplase and pro-urokinase (both P values <0.05). The incidence of intracranial hemorrhage had no statistical differences among different thrombolytics (all P values >0.05). The results of area under the cumulative ranking curve which ranked effectiveness of all thrombolytics showed that rhTNK-tPA had the best effectiveness and urokinase had the relative worst effectiveness among different thrombolytics.ConclusionsThe current evidence shows that domestic rhTNK-tPA may be effective in thrombolytic treatment. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.