Marshall J C, Waxman H L, Sauerwein A, Gilchrist I, Kurnik P B
Division of Cardiology, Cooper Hospital/University Medical Center, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Camden.
Am J Cardiol. 1990 Oct 1;66(10):773-8. doi: 10.1016/0002-9149(90)90350-a.
The clinical, angiographic and demographic characteristics of 42 patients with low-grade (less than 50%) residual stenosis at the infarct lesion after thrombolysis for acute myocardial infarction (MI) were assessed. The study group (group I) represented 21% of 198 consecutive patients receiving thrombolytic therapy over a 59-month period. Data on the 156 remaining patients were pooled for comparison (group II). Group I patients were predominantly men (86%) who were cigarette smokers (81%). Group II patients were predominantly men (75%, p greater than 0.10) but were significantly older (52 +/- 12 vs 56 +/- 10 years, p = 0.02). Prior acute MI or angina was unusual in group I. Sixty percent had no significant (greater than 50%) residual coronary artery disease while 25% had residual single artery disease. Average significant (greater than 50% diameter stenosis) residual vessel disease was 0.6 +/- 1.0 for group I and 1.9 +/- 0.9 for group II (p less than 0.001). In group I, average residual infarct lesion diameter stenosis was 36 +/- 7% in the right anterior oblique and 34 +/- 8% in the left anterior oblique views. Thirty-nine group I patients were discharged with medical therapy and 100% follow-up was obtained over a mean interval of 18 +/- 17 months. Fifteen patients experienced chest pain after acute MI accounting for 17 discrete events. Fifty-nine percent of group I had a benign course on follow-up. Eight events were classified as unstable angina, 4 as acute MI and 5 as atypical angina. Documented coronary vasospasm occurred in 3.(ABSTRACT TRUNCATED AT 250 WORDS)
对42例急性心肌梗死（MI）溶栓治疗后梗死病变处残留狭窄程度较低（小于50%）的患者的临床、血管造影及人口统计学特征进行了评估。研究组（I组）占59个月内连续接受溶栓治疗的198例患者的21%。将其余156例患者的数据汇总用于比较（II组）。I组患者以男性（86%）和吸烟者（81%）为主。II组患者也以男性为主（75%，p>0.10），但年龄明显较大（52±12岁 vs 56±10岁，p = 0.02）。I组既往急性MI或心绞痛情况不常见。60%的患者无明显（大于50%）残留冠状动脉疾病，25%有残留单支动脉疾病。I组平均明显（直径狭窄大于50%）残留血管疾病为0.6±1.0，II组为1.9±0.9（p<0.001）。在I组中，右前斜位平均残留梗死病变直径狭窄为36±7%，左前斜位为34±8%。39例I组患者接受药物治疗出院，平均随访间隔18±17个月，随访率100%。15例患者急性MI后出现胸痛，共17次独立事件。I组59%的患者随访过程呈良性病程。8次事件分类为不稳定型心绞痛，4次为急性MI，5次为不典型心绞痛。有3例记录到冠状动脉痉挛。（摘要截断于250字）
