Sarmiento R A, Blüguermann J J, González Mora R C, Riccitelli M A, Bertolasi C A
Cardiology Division, Hospital Cosme Argerich, Buenos Aires, Argentina.
Am Heart J. 1989 Nov;118(5 Pt 1):888-92. doi: 10.1016/0002-8703(89)90219-6.
In 72 patients who received streptokinase within 6 hours of the onset of an acute myocardial infarction (AMI), the relationship between the presence of a previous coronary event and the severity of the residual coronary artery stenosis was studied. Fifty-five patients were either asymptomatic or had recent onset angina (less than 5 days) before AMI (group A) and 17 patients had chronic angina (greater than 1 year) before AMI (group B). Coronary angiograms were performed at 20 days (range 15 to 25 days). Patency of the infarct-related artery was greater in group A: 43 of 55 patients (78%) versus 8 of 17 patients (47%) in group B (p less than 0.05). Residual stenosis was less than 70% in 21 patients of group A (49% of patent arteries), whereas it manifested in none of eight patients with patent arteries in group B (p less than 0.01). This suggests that thrombosis was a major component of the coronary artery narrowing in group A patients, while it is more likely that thrombus only completes a previously severe (greater than 70%) coronary artery stenosis in patients with long-standing angina before AMI.
在72例急性心肌梗死（AMI）发病6小时内接受链激酶治疗的患者中，研究了既往冠状动脉事件的存在与残余冠状动脉狭窄严重程度之间的关系。55例患者在AMI前无症状或近期发作心绞痛（少于5天）（A组），17例患者在AMI前有慢性心绞痛（超过1年）（B组）。在20天（范围15至25天）时进行冠状动脉造影。梗死相关动脉的通畅率在A组更高：55例患者中有43例（78%），而B组17例患者中有8例（47%）（p<0.05）。A组21例患者（占通畅动脉的49%）残余狭窄小于70%，而B组8例通畅动脉患者中无一例出现残余狭窄（p<0.01）。这表明血栓形成是A组患者冠状动脉狭窄的主要成分，而在AMI前有长期心绞痛的患者中，血栓更可能只是使先前严重（超过70%）的冠状动脉狭窄变得完全。
