Schwarz F, König B, Tillmanns H, Schuler G, Manthey J, Dietz R, Kübler W, Olschewski M, Scheurlen H
Dtsch Med Wochenschr. 1987 Feb 27;112(9):331-4. doi: 10.1055/s-2008-1068052.
A systemic and intracoronary thrombolytic treatment was carried out in 217 patients with acute transmural myocardial infarction between March 1980 and March 1985. 141 patients were only treated with thrombolysis, and 76 were additionally treated by balloon dilation in the same session. Indications for additional balloon dilation were unsuccessful thrombolysis as well as a residual stenosis of more than 50% after primarily successful thrombolysis. Age, sex, proportion of patients with anterior and posterior wall infarction as well as with 1, 2 and 3-vessel disease did not significantly differ in the two groups. The result of therapy (complete reperfusion) was less after thrombolysis than after thrombolysis with balloon dilation (63% as compared to 88%, P less than 0.0003). The patients who were only treated with thrombolysis had a more unfavorable three-year actuarial survival than those in whom thrombolysis and balloon dilation were carried out (70% as compared to 90%, P less than 0.02).
additional balloon dilation in thrombolytic treatment of acute transmural myocardial infarction improves the long-term prognosis.
1980年3月至1985年3月期间，对217例急性透壁性心肌梗死患者进行了全身及冠状动脉内溶栓治疗。141例患者仅接受溶栓治疗，76例在同一疗程中还接受了球囊扩张术。额外进行球囊扩张术的指征为溶栓失败以及初次溶栓成功后残余狭窄超过50%。两组患者的年龄、性别、前壁和后壁梗死患者比例以及单支、双支和三支血管病变患者比例无显著差异。溶栓治疗后的疗效（完全再灌注）低于溶栓联合球囊扩张术（分别为63%和88%，P<0.0003）。仅接受溶栓治疗的患者三年精算生存率低于接受溶栓和球囊扩张术的患者（分别为70%和90%，P<0.02）。
急性透壁性心肌梗死溶栓治疗中额外进行球囊扩张术可改善长期预后。
