急性心肌梗死静脉溶栓后早期和晚期冠状动脉造影的改变

对100例急性心肌梗死（AMI）患者应用尿激酶和链激酶静脉溶栓后进行早期和晚期的冠状动脉（冠脉）造影（CAG），结果发现：100例AMI溶栓再通成功60例，失败40例，再通率60．0％。CAG示有残留血栓的84例（84．0％），其中40例（47．6％）为冠脉完全阻塞。早期溶栓成功的60例及溶栓和补救性经皮腔内冠脉成形术（PTCA）均失败的8例，经3～4周后再次CAG发现，有8例狭窄加重，10例狭窄减轻。表明：AMI是由突然冠脉血栓性闭塞所致并可用溶栓剂或机械的方法使闭塞的冠脉再通。溶栓通常是不完全的，使用PTCA可作为改善严重残留狭窄病变的重要疗法。

Early and late angiographic changes after thrombolysis of acute myocardial infarction

Early and late angiographic results of 100 patients with AMI who were received urokinase or streptokinase for thrombolysis from March 1994 through June 1997 were analysed. As a result, 60 patients were successful reper fusion, 40 patients were failure. The reperfusion rate was 60%. There were residual thrombus in 84 patients (84. 0% ),and in 40 patients (47. 6% ) of them were coronary occlusion of thrombus. Angiography again after 3 to 4 weeks,in 60 patients of succesful reper fusion and in 8 patients failed on rescue PTCA there were 8 patients became worse,and 10 patients became better. This suggested that AMI was caused by sudden coronary occlusion of thrombus and could be opened by using emzyme or mechanical method. But usually used thrombolysis was not perfect,and PTCA might be as an important method to improve serious residual stenosis.