Tousoulis D, Andreotti F, Hackett D, Haider A W, Maseri A, Davies G
Cardiology Unit, Royal Postgraduate Medical School, Hammersmith Hospital, London.
Br Heart J. 1995 Sep;74(3):229-34. doi: 10.1136/hrt.74.3.229.
To assess the frequency of early remodelling of coronary stenosis morphology after thrombolytic treatment in patients with acute myocardial infarction.
Coronary angiograms were analysed by a computerised edge detection analysis system. Coronary stenosis severity was measured and morphology classified as smooth or complex.
Coronary arteriograms were obtained approximately 90 min and 24 h after thrombolytic treatment from 40 patients with acute myocardial infarction.
Stenosis morphology was complex in 22 patients (65%) and smooth in 11 (32%) 90 min after thrombolysis. The morphology of 11 (50%) complex coronary stenoses and three (27%) smooth stenoses had changed at 24 h (P < 0.05). The transition from complex to smooth was associated with a reduction in stenosis severity from 65 (4)% to 51 (5)% (P < 0.05). The stenosis severity was 63 (4)% and 60 (5)% in those with persistently complex morphology, and 56 (7)% and 50 (5)% in those with persistently smooth morphology at 90 min and 24 h respectively (NS).
Transition of morphology from complex to smooth within 24 h is common. This transition is associated with a reduction in stenosis severity of a degree greater than that found in persistently smooth stenoses over the same interval. 50% of stenoses are smooth at 24 h.
评估急性心肌梗死患者溶栓治疗后冠状动脉狭窄形态早期重塑的发生率。
采用计算机边缘检测分析系统对冠状动脉造影进行分析。测量冠状动脉狭窄严重程度，并将形态分为光滑型或复杂型。
对40例急性心肌梗死患者在溶栓治疗后约90分钟和24小时进行冠状动脉造影。
溶栓后90分钟，22例患者（65%）的狭窄形态为复杂型，11例（32%）为光滑型。24小时时，11例（50%）复杂冠状动脉狭窄和3例（27%）光滑狭窄的形态发生了改变（P<0.05）。从复杂型转变为光滑型与狭窄严重程度从65（4）%降至51（5）%相关（P<0.05）。90分钟和24小时时，持续为复杂形态的患者狭窄严重程度分别为63（4）%和60（5）%，持续为光滑形态的患者分别为56（7）%和50（5）%（无显著性差异）。
24小时内狭窄形态从复杂型转变为光滑型很常见。这种转变与狭窄严重程度的降低相关，降低程度大于同一时间段内持续为光滑狭窄的情况。24小时时50%的狭窄为光滑型。
