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目的：了解溶栓治疗后冠状动脉再通的临床标准的准确性。方法：以冠状动脉造影为标准，对冠状动脉再通的临床标准进行双盲诊断试验研究。７３例急性心肌梗死患者在静脉溶栓治疗后２小时内接受冠状动脉造影检查。结果：以《中华心血管病杂志》编委会推荐的参考方案的标准判断４０例再通，３３例未通；以冠状动脉造影判断４４例再通，２９例未通。参考方案标准的敏感度为６８．２％，特异度为６５．５％，临床准确度为６７．１％。结论：目前临床沿用的参考方案的标准是较好的判断标准。试图改变其中某些标准的方法不能增加其敏感度和准确度。在对假阳性及假阴性患者进行分析时发现：ＳＴ段在溶栓治疗后２小时内不能迅速下降是影响其临床准确度的原因；不同类型心律失常预报临床再通的价值不同，且与心肌梗死部位有关。
OBJECTIVES: To understand the accuracy of the clinical criteria for coronary recanalization following thrombolytic therapy. Methods: Double-blind diagnostic test was performed on the clinical criteria of coronary recanalization with coronary angiography as the standard. 73 patients with acute myocardial infarction underwent coronary angiography within 2 hours after intravenous thrombolysis. Results: According to the standard recommended by the editorial board of “Journal of Cardiovascular Diseases of China”, 40 cases were recanalized and 33 cases were failed; 44 cases were recanalized by coronary angiography, and 29 cases failed. The sensitivity of the reference protocol standard was 68.2%, the specificity was 65.5% and the clinical accuracy was 67.1%. Conclusion: The standard of clinical reference scheme is a better criterion. Attempts to change some of these standards do not increase their sensitivity and accuracy. Analysis of false-positive and false-negative patients found that: ST segment in 2 hours after thrombolytic therapy can not be rapidly decreased is the clinical accuracy of the reasons; different types of arrhythmia prediction clinical recanalization of different values, and with myocardial infarction related.