目前,溶栓疗法已广泛用于治疗急性心肌梗塞 (AMI),以降低死亡率及保护左室功能,但与梗塞相关动脉的继发性再梗塞的危险性增加。有冠脉造影研究提示,溶栓疗法后动脉早期再梗塞的发生率为20%,而再梗塞则与往后的心脏损害及死亡率有关。为此,作者采集重复溶栓疗法的31例患者,以探讨本疗法的安全性及疗效。病人和方法本研究对象为31例曾接受溶栓治疗的 AMI 患者,男22例,女9例,平均年龄58±9岁。首次采用溶栓治疗的指征包括溶栓前缺血性胸痛持续6小时以上;两个肢导联或 V_4～V_6ST 段抬高≥1mm,或 V_1～V_3导联抬高≥2mm。首次溶栓23例采用链激酶(SK)150万 U 在30分钟内静滴,8例采用重组组织型纤溶酶原激活剂(rt-PA)100mg 在3小时内静滴。所有患者在入院后均服用阿司匹林50～300mg/d, Thrombolytic therapy is currently widely used to treat acute myocardial infarction (AMI) to reduce mortality and protect left ventricular function, but the risk of secondary reinfarction with infarct-related arteries increases. Coronary angiography studies suggest that the incidence of early re-infarction of arteries after thrombolysis is 20%, whereas reinfarction is associated with subsequent heart damage and mortality. To this end, the authors collected 31 patients with repeated thrombolytic therapy in order to explore the safety of the therapy and efficacy. Patients and Methods The subjects were 31 AMI patients who had undergone thrombolytic therapy. There were 22 males and 9 females, with an average age of 58 ± 9 years. Indications for first use of thrombolytic therapy included ischemic chest pain prior to thrombolytic therapy lasting more than 6 hours; elevation of ≥1 mm in the lead or V_4 to V_6 ST segment of the two limbs, or elevation of ≥2 mm in the V_1 to V_3 lead. Thrombolytic therapy in 23 patients with intravenous streptomycin (SK) 1.5 million U intravenous infusion within 30 minutes, 8 patients with recombinant tissue-type plasminogen activator (rt-PA) 100mg intravenous infusion within 3 hours. All patients were taking aspirin 50 ~ 300mg / d after admission,