Grand A, Pernot F, Delaye J, Huret J F, Fichter P, Finet G
Service de cardiologie, Centre hospitalier de Valence, France.
Arch Mal Coeur Vaiss. 1989 Jan;82(1):51-6.
Thirty patients (26 men, 4 women) aged from 32 to 73 years (mean 54 years) who developed anterior (14 cases) or posterior (16 cases) myocardial infarction received intravenous streptokinase in doses of 1,500,000 units 2 to 10 hours (mean 4 hours) after the onset of infarction. Coronary angiography, performed 18.6 days on average after thrombolysis, showed a distinct predominance of asymmetrical stenosis with irregular walls and a narrow neck (10 cases, 33 p. 100) or of complete occlusion (12 cases, 40 p. 100) in the artery responsible for the infarction. Complete occlusion probably was the ultimate stage of stenosis. In contrast, the various angiographic images observed in arteries unrelated to the infarction were evenly distributed. The radiological morphology of coronary arterial lesions after a recent infarction is suggestive of ruptured atheromatous plaque, sometimes complicated by thrombosis in situ. Identical images are seen in unstable angina. These findings indicate that one single therapeutic approach should be applied to the most severe types of coronary disease due to atherosclerosis.
30例患者（26例男性，4例女性），年龄32至73岁（平均54岁），发生前壁心肌梗死（14例）或后壁心肌梗死（16例），在梗死发作后2至10小时（平均4小时）接受了150万单位剂量的静脉链激酶治疗。溶栓后平均18.6天进行的冠状动脉造影显示，在梗死相关动脉中，明显以不对称狭窄为主，伴有不规则管壁和狭窄颈部（10例，占33%）或完全闭塞（12例，占40%）。完全闭塞可能是狭窄的最终阶段。相比之下，在与梗死无关的动脉中观察到的各种血管造影图像分布均匀。近期梗死冠状动脉病变的放射学形态提示动脉粥样硬化斑块破裂，有时并发原位血栓形成。不稳定型心绞痛中也可见相同图像。这些发现表明，对于最严重类型的动脉粥样硬化性冠状动脉疾病应采用单一的治疗方法。
