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目的：观察静脉溶栓治疗对急性心肌梗塞（ＡＭＩ）患者远期预后的影响。方法：采用超声心动图、２４小时动态心电图、心电图运动试验及心室晚电位检查，对９４例接受溶栓治疗的ＡＭＩ患者进行６个月～３年的随访。结果：在６个月～３年的随访中，前壁再通组左房内径（ＬＡＤ）、左室舒张末内径（ＬＶＥＤ）和左室射血分数（ＬＶＥＦ）均明显短于前壁未通组（Ｐ均＜０．０５）；而下壁再通组与未通组ＬＡＤ、ＬＶＥＤ和ＬＶＥＦ无明显差别。再通组各种心律失常的发生率明显低于未通组，再通组的运动耐量明显高于未通组（Ｐ均＜０．０５）。结论：静脉溶栓对改善前壁心肌梗塞患者远期心功能疗效显著，对下壁心肌梗塞患者心功能改善不明显；但静脉溶栓对前壁或下壁心肌梗塞患者，在减少远期心律失常的发生，增强运动耐量和提高生活质量方面均有着重要意义。
Objective: To observe the effect of intravenous thrombolytic therapy on long-term prognosis in patients with acute myocardial infarction (AMI). Methods: Ninety-four AMI patients undergoing thrombolytic therapy were followed up for 6 months to 3 years by echocardiography, 24-hour Holter, ECG exercise test and ventricular late potentiometry. Results: Left atrium diameter (LAD), left ventricular end-diastolic diameter (LVED) and left ventricular ejection fraction (LVEF) were significantly shorter than those of the anterior wall at 6 months to 3 years of follow-up Group (all P <0.05). However, there was no significant difference between LAD, LVED and LVEF in inferior wall recanalization group and unreasonable group. The incidence of arrhythmias in the recanalization group was significantly lower than that in the non-recanalization group, and the exercise tolerance in the recanalization group was significantly higher than that in the non-recanalization group (all P <0.05). Conclusions: Intravenous thrombolysis has a significant effect on improving long-term cardiac function in patients with anterior myocardial infarction, and has no significant improvement in cardiac function in patients with inferior myocardial infarction. However, intravenous thrombolysis in patients with anterior or inferior myocardial infarction may reduce long-term cardiac rhythm The occurrence of disorders, increased exercise tolerance and improve the quality of life are of great significance.