Leisch F, Herbinger W
Wien Med Wochenschr. 1984 Dec 31;134(23-24):550-4.
A report is presented on 21 patients admitted with acute myocardial infarction in whose pain duration had not exceeded three hours. The coronary angiogram revealed occlusion of the supply-vessel to the infarcted area in 18 patients and only subtotal stenosis in the 3 remaining cases. Intracoronary administration of streptokinase (2000 to 4000 U/min) achieved thrombolysis in 15 out of 18 patients (83%) with thrombotic occlusion. All patients with exception of 2 patients revealed after thrombolysis a greater than or equal to 80% remaining stenosis. 2 patients without successful recanalisation died due to pump failure on the first or fourth day, respectively, following myocardial infarction. Reinfarction occurred in 2 patients out of successful treated cases, 4 patients required aortocoronary bypass-surgery for impending reinfarction or unstable angina pectoris. Angiographic control in the fourth week following myocardial infarction demonstrated reocclusion of the corresponding vessel in 3 cases, 2 of whose had a reinfarction. There was no change in the mean ejection fraction in the patients with persistent recanalisation between the acute and the chronic stage of infarction.
报告了21例急性心肌梗死患者，其疼痛持续时间未超过3小时。冠状动脉造影显示，18例患者梗死区域的供血血管闭塞，其余3例仅有次全狭窄。在18例血栓性闭塞患者中，15例（83%）通过冠状动脉内注射链激酶（2000至4000 U/分钟）实现了溶栓。除2例患者外，所有患者溶栓后残余狭窄均大于或等于80%。2例再通未成功的患者分别在心肌梗死后第一天或第四天因泵衰竭死亡。成功治疗的病例中有2例发生再梗死，4例因即将发生再梗死或不稳定型心绞痛需要进行主动脉冠状动脉搭桥手术。心肌梗死后第四周的血管造影检查显示，3例相应血管再次闭塞，其中2例发生了再梗死。梗死急性期和慢性期持续再通的患者平均射血分数无变化。
