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急性心肌梗塞早期溶栓治疗与临床效果密切相关,冠状动脉闭塞的再通可降低急性心肌梗塞的死亡率,有利于挽救濒死心肌,限制梗塞面积,保持其收缩功能。临床常用静脉溶栓,有报道再通率仅在60-70％之间,而且评价血管再通主要是通过临床的间接指征。但是单凭临床指征判断血管再通准确性小,只有冠状造影才是评价血管再通的可靠标准。我院自1999年8月开展了冠状动脉内溶栓术,通过冠状动脉造影证实冠状动脉内溶栓明显增加了急性心肌梗塞血管再通率,血管再通患者近期病死率及各种严重并发症明显低于血管未通患者,在远期随访可见血管再通较未通者生存机会明显增加,说明急性心肌梗塞使用冠脉内溶栓对早期血管再通具有十分重要的意义。
Early thrombolytic therapy of acute myocardial infarction is closely related to the clinical effect. Recanalization of coronary occlusion can reduce the mortality rate of acute myocardial infarction, help to save dying myocardium, limit infarct size and maintain its systolic function. Clinical intravenous thrombolysis, there are reports of pass rates of only 60-70%, and the evaluation of recanalization is mainly through clinical indications. However, the accuracy of recanalization alone based on clinical indications is small, and only coronary angiography is a reliable measure of recanalization. Our hospital since August 1999 carried out intra-coronary thrombolysis, confirmed by coronary angiography intra-coronary thrombolysis significantly increased the rate of recanalization of acute myocardial infarction, recanalization of patients with recent mortality and a variety of serious complications Obviously lower than the patients with vascular failure, in the long-term follow-up showed no significant improvement in the chances of revascularization compared with the failure, indicating that the use of coronary thrombolysis in acute myocardial infarction on the early revascularization is of great significance.