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冠脉内膜病损,冠脉痉挛与血小板激活三者之间的动力学相互作用可导致冠脉血栓形成,构成急性透壁性心肌梗塞最常见的致病因素。Dewood等对517名急性心肌梗塞患者(AMI)在症状发生后24小时内进行冠脉造影证实:80%以上病例在透壁性AMI的初期(4～6小时)发现有冠脉血栓。73名冠脉造影拟有血栓形成的病例中,急症冠脉旁路手术时证实有血栓者65例。1979年,Rentrop证明,在AMI早期,冠状动脉内注入链激酶(SK)可使已经闭塞了的血管再通。本文就溶栓理论、溶栓剂、溶栓作用等新进展综述如下: 溶栓理论心肌梗塞范围(Infarct Size,IS)的大小是泵衰竭的决定因素,后者是住院死亡的主要原因。影响IS的因素颇多,其中以冠脉梗阻程度与时程最重要。Jennings等实验表明:缺血所致的心内膜
Coronary intimal lesions, coronary spasm and platelet activation of the three interactions between the three can lead to coronary thrombosis, constitute the most common cause of acute transmural myocardial infarction risk factors. Dewood et al. Coronary angiography in 517 acute myocardial infarction patients (AMI) within 24 hours of onset of symptoms: Coronary thrombi were found in more than 80% of cases at the initial (4-6 hours) transmural AMI. Of the 73 patients who underwent coronary angiography with thrombosis, 65 had confirmed thromboembolism during acute coronary bypass surgery. In 1979, Rentrop demonstrated that the injection of streptokinase (SK) into the coronary artery can recapture the already occluded vessels early in the AMI. Here are some recent advances in thrombolytic theory, thrombolytic agents, and thrombolysis: Thrombolytic Theory The size of the Infarct Size (IS) is the determinant of pump failure, which is the major cause of hospital mortality. Many factors affect the IS, of which the degree and duration of coronary artery obstruction is the most important. Jennings and other experiments show that: endocardial ischemia caused by