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为评价溶栓失败急性心肌梗塞（AMI）行补救性经皮腔内冠状动脉成形术（PTCA）的疗效及安全性，对35例AMI患者溶栓后90min行冠状动脉造影。根据梗塞相关动脉开通情况，16例成功者（甲组）中12例7～21d后行延迟PTCA治疗；19例失败者（乙组）中13例（乙1组）即刻行补救性PTCA，其余6例（乙2组）溶栓失败而未行PTCA者给一般药物治疗。结果表明，甲级中12例行延迟PTCA，成功11例（91．6％），正例于PTCA中出现冠状动脉急性闭塞并致小灶下壁心肌梗塞；乙1组13例行补救PTCA，全部成功（100％）。甲组住院期总心脏事件发生率（19％）与乙1组（23％）相似，且出院前心功能无显著差异。而乙2组6例中住院期死亡率（33％）及总心脏事件发生率（50％）增高。提示AMI溶栓失败患者补救PTCA成功率高、并发症少，能减少住院期心脏事件并促进左心室功能改善。
To evaluate the efficacy and safety of salvage PTCA with thrombolytic failure in acute myocardial infarction (AMI), coronary angiography was performed in 90 patients with AMI at 90 min after thrombolysis. According to the situation of infarction-related artery opening, 12 of the 16 successful patients (Group A) underwent delayed PTCA after 7 to 21 days, while 13 of the 19 losers (Group B) received rescue PTCA immediately. Six patients (Group B) thrombolytic failure without PTCA to general medical treatment. The results showed that in 12 cases of Grade A, delayed PTCA was successful in 11 cases (91.6%). Positive PTCA occured in acute coronary artery and caused inferior myocardial infarction. In group B, 13 patients received PTCA remediation Success (100%). The incidence of total inpatient cardiac events in Group A (19%) was similar to that in Group B (23%), and there was no significant difference in cardiac function before discharge. However, in group B 2, in-hospital mortality (33%) and total cardiac event (50%) increased in 6 patients. Prompt AMI thrombolytic failure in patients with high recovery PTCA success rate, fewer complications, can reduce in-hospital cardiac events and improve left ventricular function improved.