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判定溶栓疗法成功的方法之一是与梗塞相关冠脉的早期再通情况。心肌梗塞溶栓疗法研究(TIMI)规定再通的标准是:冠脉闭塞为0级,轻微灌注为Ⅰ级,部分灌注为Ⅱ级,完全灌注为Ⅱ级。0-Ⅰ级为溶栓无效,Ⅱ～Ⅲ级判为成功。Karagounis等对359例发病后4小时内,用链激酶或APSAC溶栓的急性心肌梗塞(AMI)患者的心肌酶指数和心电图指数,与冠脉再灌注分级进行对比分析。血清酶及心电图均进行系列检测。决定再通的时间为溶栓开始后90～240(中数130)分钟,由不知病情的两名医生观察分析决定再通级别。两种药的结果相似,故结合起来分析。首次用药后的冠脉再通情况如下:0级72例(20%),Ⅰ级27例(8%),Ⅱ级58例(16%)及Ⅲ级202例(56%)。然后在第一次冠脉造影后18～48小
One of the ways to determine the success of thrombolytic therapy is the early recanalization of infarct-related coronary arteries. Thrombolytic therapy in patients with myocardial infarction (TIMI) regulations recanalization criteria are: coronary occlusion of 0, mild perfusion grade Ⅰ, partial perfusion grade Ⅱ, complete perfusion grade Ⅱ. 0-Ⅰ grade for thrombolytic invalid, Ⅱ ~ Ⅲ grade sentence was successful. Karagounis and other 359 patients within 4 hours after onset of streptokinase or APSAC thrombolytic acute myocardial infarction (AMI) patients with myocardial enzyme index and electrocardiogram index, and coronary reperfusion grading comparison. Serum enzyme and electrocardiogram are a series of tests. Decided to re-open the time for the thrombolytic start 90 ~ 240 (median 130) minutes, by the two doctors do not know the condition of observation and analysis decided to pass the grade. The results of the two drugs are similar, so combined analysis. Coronary recanalization after initial administration was as follows: Grade 0 72 (20%), Grade I 27 (8%), Grade II 58 (16%) and Grade III 202 (56%). Then 18 to 48 hours after the first coronary angiography