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目的：对比评价急性心肌梗塞（ＡＭＩ）的各种再灌注治疗对缺血性心肌挽救的疗效。材料和方法：３５例ＡＭＩ患者被分为接受静脉内组织纤溶酶原激活剂的ＩＶＴ组，接受急症经皮冠脉成形术的ＰＴＣＡ和ＩＶＴ＋ＰＴＣＡ组。用碘１２３标记的β甲基碘苯十五烷酸（１２３ＩＢＭＩＰＰ）和铊２０１（２０１Ｔｌ）双核素心肌断层显像分别评价心肌的缺血范围及梗塞面积，并计算出心肌挽救指数（ＳＩ）。结果：虽然三组间缺血范围无显著差别，但ＰＴＣＡ组的梗塞面积却明显大于ＩＶＴ和ＩＶＴ＋ＰＴＣＡ组。因而，ＩＶＴ和ＩＶＴ＋ＰＴＣＡ组的ＳＩ显著大于ＰＴＣＡ组。结论：ＩＶＴ＋ＰＴＣＡ是治疗ＡＭＩ的理想方案之一。
Objective: To evaluate the efficacy of various reperfusion treatments for ischemic myocardial salvage in patients with acute myocardial infarction (AMI). MATERIALS AND METHODS: Thirty-five patients with AMI were divided into IVT group receiving intravenous tissue plasminogen activator and PTCA and IVT + PTCA group receiving emergency percutaneous coronary angioplasty. Iodine 123 labeled β-methyl iodobenzene pentadecanoic acid (123I MBIPP) and thallium 201 (201Tl) dual-radionuclide myocardial perfusion imaging were evaluated myocardial ischemia and infarct size, and to calculate the myocardial salvage Index (SI). Results: Although there was no significant difference in the extent of ischemia between the three groups, the infarct size was significantly greater in the PTCA group than in the IVT and IVT + PTCA groups. Thus, SI was significantly greater in the IVT and IVT + PTCA groups than in the PTCA group. Conclusion: IVT + PTCA is one of the ideal ways to treat AMI.