Satler L F, Kent K M, Green C E, Pearle D L, Pallas R S, Del Negro A A, Rackley C E
Cardiovasc Clin. 1986;16(3):39-52.
Emergency cardiac catheterization and angiography in patients have resulted in an appreciation of the pathogenesis of AMI and the efficacy of thrombolytic therapy. Simple reperfusion of the infarcted myocardium, however, does not necessarily guarantee myocardial salvage, and preliminary studies have been somewhat confusing as to its beneficial effects. Metabolic support of the ventricle during early reperfusion may enhance left ventricular performance. Although the potential effects of thrombolytic therapy are still unclear, the routine administration of these agents has resulted in more frequent performance of early coronary angiography, with the result that appropriate therapeutic decisions can be made immediately regarding medical treatment, coronary angioplasty, or complete myocardial revascularization. In fact, in prolonged chest pain syndromes, emergency angiography may play a very important role in establishing appropriate initial therapy early in the course of hospitalization, potentially lowering mortality, morbidity, and cost. These issues will be answered ultimately only by carefully designed long-term randomized trials.
对患者进行紧急心脏导管插入术和血管造影，使人们对急性心肌梗死（AMI）的发病机制以及溶栓治疗的疗效有了更深入的认识。然而，单纯使梗死心肌再灌注并不一定能保证挽救心肌，并且关于其有益效果的初步研究有些令人困惑。早期再灌注期间对心室的代谢支持可能会增强左心室功能。尽管溶栓治疗的潜在效果仍不明确，但这些药物的常规使用已导致更频繁地进行早期冠状动脉造影，结果是可以立即就药物治疗、冠状动脉血管成形术或完全心肌血运重建做出适当的治疗决策。事实上，在持续性胸痛综合征中，紧急血管造影可能在住院早期确定适当的初始治疗方面发挥非常重要的作用，有可能降低死亡率、发病率和成本。只有通过精心设计的长期随机试验才能最终回答这些问题。
