Mickley H, Junker A, Møller M
Department of Cardiology B, Odense University Hospital, Denmark.
Cardiology. 1994;84(2):121-5. doi: 10.1159/000176530.
In patients with acute myocardial infarction a substantial reduction in mortality can be achieved by early intravenous thrombolytic therapy. The beneficial effect of thrombolysis on left ventricular function is relatively small, and it seems unlikely that this minor improvement alone can be responsible for the reduction in cardiac death. So far it has not been clearly established how thrombolytic therapy affects postinfarction myocardial ischemia. From studies evaluating ST segment changes on exercise testing or ambulatory monitoring it is concluded that thrombolysis probably results in a reduction of residual ischemia. The reduced ischemic burden is proposed to be one important pathophysiological mechanism underlying the frequently observed improvement in hemodynamic stress test variables following thrombolytic treatment.
对于急性心肌梗死患者，早期静脉溶栓治疗可显著降低死亡率。溶栓对左心室功能的有益作用相对较小，仅靠这一微小改善似乎不太可能导致心脏死亡的减少。到目前为止，溶栓治疗如何影响梗死后心肌缺血尚未明确。从评估运动试验或动态监测中ST段变化的研究得出结论，溶栓可能会减少残余缺血。缺血负担减轻被认为是溶栓治疗后血流动力学应激试验变量常见改善的重要病理生理机制之一。
