Thrombolysis in Acute Myocardial Infarction Using Intracoronary Streptokinase: Assessment by Thallium‐201 Scintigraphy
Thrombolysis in Acute Myocardial Infarction Using Intracoronary Streptokinase: Assessment by Thallium‐201 Scintigraphy
复制标题
使用冠状动脉内链激酶溶栓治疗急性心肌梗死：铊-201 闪烁扫描评估
DOI：
10.1161/01.cir.66.3.658
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发表时间：
1982
期刊：
影响因子：
37.8
通讯作者：
W. Kubler
中科院分区：
文献类型：
--
作者：
G. Schuler;F. Schwarz;M. Hofmann;H. Mehmel;J. Manthey;W. Maurer;B. Rauch;H. Herrmann;W. Kubler
对21例出现症状后4小时内入院的急性心肌梗死患者，采用7针孔铊-201显像对其进行链激酶冠脉内纤溶前、1小时、24小时的观察。从原始的七个针孔数据重建的心肌横截面评估铊-201灌注缺损的大小，并以左心室周长的分数表示。16例患者在症状出现后3.9±1.6小时内实现再通（A组）。在这些患者中，灌注缺损的大小在24小时从36±17%下降到19±15% （p < 0.001）。干预后1小时重新分配未发现显著变化。在5例患者中，冠状动脉内纤溶不成功，血管仍然闭塞（B组）。干预前铊-201灌注缺损占左室周长（40±15%）；纤溶后1小时（37±16%）和24小时（41±15%）基本保持不变。灌注缺损在广泛侧枝供应缺血区或受影响冠状动脉次全闭塞的患者中减少最多。我们的结论是，成功的冠状动脉内纤溶可以减少许多急性心肌梗死患者的铊-201灌注缺陷的大小。最终结果的一个重要因素可能是在症状发生后约4小时左右实现再灌注时，存在由广泛侧枝供应的残余冠状动脉血流或受影响冠状动脉的次全闭塞。
Twenty-one patients with acute myocardial infarction, admitted to the hospital within 4 hours after the onset of symptoms, were studied by seven-pinhole thallium-201 scintigraphy before and I hour and 24 hours after intracoronary fibrinolysis using streptokinase. The size of the thallium-201 perfusion defect was assessed from myocardial cross sections reconstructed from the original seven-pinhole data and expressed as a fraction of left ventricular circumference.Recanalization was achieved in 16 patients within 3.9 ± 1.6 hours after onset of symptoms (group A). In these patients, the size of the perfusion defect had decreased from 36 ± 17% to 19 ± 15% (p < 0.001) at 24 hours. No significant change was detected by redistribution at 1 hour after the intervention. In five patients, intracoronary fibrinolysis was unsuccessful, and the vessel remained occluded (group B). The thallium-201 perfusion defect affected 40 ± 15% of the left ventricular circumference before the intervention; it remained virtually unchanged at 1 hour (37 ± 16%) and at 24 hours (41 ± 15%) after fibrinolysis. The perfusion defect was most reduced in patients with extensive collaterals supplying the ischemic area or with subtotal occlusion of the affected coronary artery.We conclude that successful intracoronary fibrinolysis may reduce the size of the thallium-201 perfusion defect in many patients with acute myocardial infarction. One important factor in the final result may be the presence of residual coronary flow supplied by extensive collaterals or by subtotal occlusion of the affected coronary artery when reperfusion is achieved around 4 hours after the onset of symptoms.
影响因子：
37.8
作者：
W. Schaper;S. Pasyk
通讯作者：
W. Schaper;S. Pasyk
急性心肌梗死进展中通过冠状动脉溶栓挽救心肌：使用冠状动脉注射铊 201 进行评估。
影响因子：
4.8
作者：
Maddahi,J;Ganz,W;Ninomiya,K;Hashida,J;Fishbein,MC;Mondkar,A;Buchbinder,N;Marcus,H;Geft,I;Shah,PK;Rozanski,A;Swan,HJ;Berman,DS
通讯作者：
Berman,DS