急性心肌梗死尿激酶溶栓成功后相关冠状动脉形态的动态观察  

Dynamic morphologic changes of infarct-related coronary artery in the patients with acute myocardial infarction after successful intravenous thrombolysis with urokinase

作　　者：李新军[1] 郭向东[1] 李春海[1] 李文惠[1] 张秀丽[1] 王爱红[1] 

机构地区：[1]河北北方学院附属第二医院心内科,张家口075100

出　　处：《中国急救医学》2007年第1期81-82,共2页Chinese Journal of Critical Care Medicine

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

关 键 词：急性心肌梗死 溶栓 冠状动脉造影 残余狭窄 

分 类 号：R542.22[医药卫生—心血管疾病]