【摘要】 目的观察急性心肌梗死(AMI)尿激酶溶栓成功后,相关冠脉形态动态改变。方法以溶栓成功的52例患者为观察对象,溶栓后120min和6个月时分别对其进行冠状动脉造影,然后用计算机辅助定量系统对溶栓后的冠脉病变处进行测量。结果溶栓后120min 52例患者中12例残余狭窄90%～99%,32例残余狭窄为70%～90%,7例残余狭窄＜70%,1例无明显狭窄；与溶栓后120min相比,溶栓后6个月时残余狭窄＞70%的患者42例无明显改善(P＞0．05)。结论AMI静脉溶栓虽可挽救一部分濒临坏死的心肌,但大部分相关冠脉仍留有明显的残余狭窄,需行经皮冠脉介入术来解决残余狭窄问题。更多还原

【Abstract】 Objective To observe dynamic morphologic changes of infarct-related coronary artery in the patients with acute myocardial infarction after successful intravenous thrombolysis with urokinase. Method 52 patients were included in the study.Coronary angiography was performed at the 120th minute and the 6 th month after thrombolysis.Degree of residual stenosis after thrombolysis was tested by QCA. Result At the 120th minute,the residual stenosis was 90%～99% in 12 patients,70%～90% in 32 pa- tients and below 70% in 7 patients.Only one patient showed no significant residual stenosis.At the 6th montb,the residual stenosis over 70% in 42 patients was not significantly improved(P＞0.05).Conclu- sion Intravenous thrombolysis can rescue dying myocardium,but residual stenosis are determined in most patients.Percutaneous coronary intervention(PCI)should be performed to improve the residual stenosis.更多还原