目的 :对比观察急性心肌梗死 ( AMI)急诊冠状动脉 (冠脉 )造影正常和异常患者的临床表现。方法 :94例 AMI患者行即刻经皮腔内冠脉成形术 ( PTCA)或溶栓治疗 ,溶栓者于溶栓开始后 90 m in行冠脉造影 ,梗死相关动脉 ( IRA)再通且无冠脉病变者为冠脉正常组 ,再通且并冠脉病变者及 PTCA成功者为冠脉异常组。记录两组患者冠心病易患因素 ,观察 ST段抬高总和 90 m in回落程度 ,比较两组患者住院期心脏事件发生率 ,并于出院前行超声心动图检查。结果 :94例患者中冠脉正常组 2 1例 ,冠脉异常组 73例。前者较后者年龄轻 ,男性、吸烟等诱因多见 ,且造影时 TIMI 3级多见 ;ST段抬高总和 90 m in回落大 ( P <0 .0 5 ) ;住院期间心脏事件发生率明显降低 ( P<0 .0 5 ) ;出院前超声心动图显示左室射血分数较大 ( P<0 .0 5 )。结论 :AMI急诊冠脉造影正常患者相对年轻 ,吸烟等诱因多见 ,住院期心功能和临床预后较好 Objective: To compare the clinical manifestations of patients with acute myocardial infarction (AMI) with normal and abnormal coronary artery (coronary artery) angiography. Methods: Ninety-four AMI patients underwent immediate percutaneous transluminal coronary angioplasty (PTCA) or thrombolytic therapy. Thrombolysis was performed on coronary angiography 90 minutes after thrombolysis and recanalization of infarct-related artery (IRA) Coronary lesions were normal coronary artery group, and then pass and coronary artery disease were successful and PTCA coronary artery abnormalities. The predisposing factors of coronary heart disease were recorded in both groups. The total 90-minute drop in ST-segment elevation was observed. The incidence of in-hospital cardiac events in both groups was compared and echocardiography was performed before discharge. Results: In 94 patients, 21 cases were coronary normal group and 73 cases were coronary abnormality group. The former than the latter young, male, smoking and other incentives more common, and angiography more common TIMI level; ST segment elevation 90 m in fall (P <0. 05); during hospitalization was significantly higher incidence of cardiac events (P <0.05). Pre-discharge echocardiography showed a large left ventricular ejection fraction (P <0.05). Conclusions: The normal AMI emergency coronary angiography patients are relatively young, smoking and other incentives more common, hospitalized cardiac function and clinical prognosis is good