Gasser R, Dienstl F
Clin Physiol. 1986 Oct;6(5):397-403. doi: 10.1111/j.1475-097x.1986.tb00070.x.
Acute myocardial infarction (AMI) can no longer be considered as a single event, but as a series of episodes. In most of the cases, the initial event may be the induction of a severe spasm of the coronary artery by vasoconstrictive substance released from aggregated platelets. These spasms are followed by dilatation, which is caused by substances set free from the ischemic tissue. Dilatation then results in a washing-out of vasoactive mediators (as well as myoglobin) and platelets, which is reflected as a peak in the blood myoglobin concentration-time curve. The local depletion of vasodilative metabolites allows a further contraction of the coronary vessel. A new accumulation of platelets then stimulates another spasm. This vicious circle (thrombo-ischemic re-entry-mechanism) is repeated several times and can be interrupted by the systemic administration of thrombolytic drugs (streptokinase).
急性心肌梗死（AMI）不再被视为单一事件，而是一系列发作。在大多数情况下，初始事件可能是聚集的血小板释放的血管收缩物质诱导冠状动脉严重痉挛。这些痉挛之后是扩张，这是由缺血组织释放的物质引起的。扩张随后导致血管活性介质（以及肌红蛋白）和血小板的清除，这表现为血液肌红蛋白浓度 - 时间曲线中的一个峰值。血管舒张代谢产物的局部耗竭使得冠状动脉进一步收缩。血小板的新聚集随后刺激另一次痉挛。这个恶性循环（血栓 - 缺血再进入机制）会重复多次，并且可以通过全身给予溶栓药物（链激酶）来中断。
