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目的:观察急性心肌梗死(AMI)尿激酶溶栓成功后相关冠状动脉(冠脉)形态动态改变。方法:以溶栓成功的42例患者为观察对象,溶栓后90min和6个月时分别对其进行冠脉造影,然后用计算机辅助定量冠脉造影系统对溶栓后的冠脉病变处进行测量。结果:溶栓后90min42例患者中5例残余狭窄为90%～95%,32例残余狭窄为70%～90%,4例残余狭窄<50%,1例无明显狭窄;与溶栓后90min相比较,溶栓后6个月时34例患者残余狭窄无明显改变(P>0.05),7例残余狭窄明显改善(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,仍需行经皮冠脉介入术来解决残余狭窄问题。
Objective: To observe the dynamic change of coronary artery (coronary artery) morphology after urokinase thrombolysis in acute myocardial infarction (AMI). Methods: Forty-two patients with successful thrombolysis were enrolled in this study. Coronary angiography was performed at 90 and 6 months after thrombolytic therapy, respectively. Coronary lesions after thrombolysis were performed by computer-assisted quantitative coronary angiography measuring. Results: Residual stenosis was 90% ~ 95% in 5 of 42 patients after the thrombolysis at 90min, residual stenosis was 70% ~ 90% in 32 patients, residual stenosis was less than 50% in 4 patients and no stenosis in 1 patient. Compared with 6 months after thrombolysis, there were no significant changes in residual stenosis in 34 patients (P> 0.05), while residual stenosis in 7 patients was significantly improved (P <0.05). Conclusion: Intravenous thrombolysis with AMI can save some of the necrosis myocardium. However, most of the related coronary arteries still have obvious residual stenosis. Percutaneous coronary intervention is still needed to solve the residual stenosis.