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目的探讨冠状动脉造影正常的急性心肌梗死的发病机制。方法51例急性心肌梗死患者均住院行尿激酶溶栓治疗辅以低分子肝素、肠溶阿司匹林等,并于急性心肌梗死后7～14d内行经皮冠状动脉造影术及左室造影术。结果本组患者冠状动脉造影结果提示梗死相关血管未见阻塞性病变,斑块<30%,冠状动脉内血流缓慢,造影剂排空延迟,冠状动脉管壁不光滑等现象。结论冠状动脉造影正常的心肌梗死其发生机制与冠状动脉痉挛及不稳定斑块破裂冠状动脉血栓形成(CATH)有关。
Objective To investigate the pathogenesis of acute myocardial infarction with normal coronary angiography. Methods 51 patients with acute myocardial infarction were treated with urokinase thrombolysis combined with low molecular weight heparin and enteric-coated aspirin. Percutaneous coronary angiography and left ventricular angiography were performed within 7-14 days after acute myocardial infarction. Results The results of coronary angiography in this group of patients showed no obstructive lesions in infarct-related blood vessels. The plaque was less than 30%. The blood flow in the coronary artery was slow. The contrast agent was delayed in emptying and the wall of the coronary artery was not smooth. Conclusions The mechanism of myocardial infarction with normal coronary angiography is related to coronary artery spasm and unstable coronary artery thrombosis (CATH).