目的观察急性心肌梗死(AMI)溶栓成功后冠脉形态学动态变化。方法选择溶栓成功的42例患者为研究对象,溶栓后10 d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10 d 42例患者中7例残余狭窄90%～99%,26例残余狭窄为70%～90%,8例残余狭窄<70%,1例无明显狭窄;与溶栓后10 d相比,溶栓后6个月时残余狭窄>70%的患者32例无明显改善(P>0.05)。结论急性心肌梗死静脉溶栓虽可挽救一部分濒临坏死的心肌,但大部分相关动脉仍留有明显的残余狭窄,需行经皮冠脉介入来解决残余再狭窄问题。 Objective To observe the changes of coronary morphology after successful thrombolysis in acute myocardial infarction (AMI). Methods Forty-two patients with successful thrombolysis were enrolled in this study. Coronary angiography was performed at 10 and 6 months after thrombolytic therapy, respectively. Coronary lesions after thrombolysis were measured by computer-assisted quantitative system. Results After 10 days of thrombolysis, residual stenosis was found in 7 of 42 patients (90% -99%), residual stenosis was 70% ~ 90% in 26 patients, residual stenosis was less than 70% in 8 patients, and no stenosis occurred in 1 patient. There was no significant improvement in 32 patients with> 70% residual stenosis at 6 months after thrombolysis (P> 0.05). Conclusion Although intravenous thrombolysis in acute myocardial infarction can save a part of the myocardium on the verge of necrosis, most of the related arteries still have obvious residual stenosis. Percutaneous coronary intervention is needed to solve the problem of residual restenosis.