目的 评价对急性冠状动脉综合征患者施行急诊冠状动脉造影的安全性与有效性。方法 自１９９６年１月至１９９９年１２月，我们共施行急诊冠状动脉造影５６８例，其中疑诊急性心肌梗死４１６例，疑诊不稳定性心绞痛１５２例。结果 ４１６例拟诊急性心肌梗死病例中，有３２８例施行了梗死相关血管的直接经皮冠状动脉腔内成形术（Ｐrimary PTCA,P-PTCA）治疗;有３２例造影发现冠状动脉梗死相关血管直径狭窄＜７５%，前向血流TIMI Ⅲ级，未行P-PTCA治疗；有１２例左主干和（或）三支血管病变患者施行急诊冠状动脉旁路移植术（CABG）；１６例左主干和（或）三支血管病变患者在主动脉内球囊反搏（IABP）辅助下，行择期CABG治疗；有８例因梗死相关血管不能确定或是不适宜P-PTCA或CABG病例接受了冠状动脉内溶栓治疗，有４例梗死相关血管细小，未行特别处理；有１３例急诊冠状动脉造影示结果正常或体表心电图判定的梗死相关血管正常。１５２例拟诊不稳定性心绞痛患者中行急诊PTCA治疗１０８例，CABG３３例，动脉造影正常８例，因弥漫性冠状动脉病变不适宜PTCA/CABG治疗，选用IABP短期辅助治疗加药物治疗维持２例。２例急性心梗和１例梗死后心绞痛患者死于术中或术后即刻。结论 对于急性冠状动脉综合征患者施行急? Objective To evaluate the safety and efficacy of emergency coronary angiography in patients with acute coronary syndrome. Methods From January 1996 to December 1999, we performed a total of 568 cases of emergency coronary angiography, of which 416 cases were suspected acute myocardial infarction and 152 cases were suspected unstable angina. Results Of the 416 cases diagnosed as acute myocardial infarction, 328 cases underwent primary percutaneous transluminal coronary angioplasty (P-PTCA) with infarct-related vessels. There were 32 cases of coronary artery infarction related vascular diameter Thrombosis was less than 75%. The antegrade flow of TIMI grade III was not treated with P-PTCA. Twelve patients with left main and / or three vessel lesions underwent emergency coronary artery bypass grafting (CABG) And / or three-vessel disease undergoing aortic balloon pump (IABP) assisted with CABG; elective coronary artery disease was diagnosed in 8 patients who were unable to confirm or not suitable for P-PTCA or CABG due to infarction Intra-arterial thrombolysis, 4 cases of infarct-related blood vessels were small, without special treatment; 13 cases of emergency coronary angiography showed normal or surface ECG to determine the infarction-related blood vessels normal. Of the 152 patients with suspected unstable angina who underwent emergency PTCA, 108 were treated with CABG, 8 with normal arterial angiography, and were unsuitable for PTCA / CABG due to diffuse coronary artery disease. Short-term adjuvant treatment with IABP and drug therapy were maintained in 2 patients. Two patients with acute myocardial infarction and one patient with post-infarction angina died at or immediately after surgery. Conclusions for patients with acute coronary syndrome acute?