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目的：动态观察急性心肌梗塞（AMI）病人早期尿激酶（UK）溶栓治疗甲襞微循环变化，并探讨其发生的可能机制，为临床AMI的治疗及再灌注损伤（RI）的预防提供理论依据。方法：运用显微电视录像系统结合加权积分法对21例AMI病人甲襞微循环进行研究。结果：再灌注即刻，血液流态恶化（P＜0．01）；再灌注心律失常发生率与血液流态积分值有关（P＜0．05）。结论；1、AMI早期UK治疗随冠脉再通，甲襞微循环特征性改变为红细胞高度聚集，白微栓大量形成即血流状态的恶化。提示纤溶的同时凝血功能亢进。支持AMI溶栓前后应用ASA、肝素等抗凝治疗。2、微循环异常改变参与AMI及RI发生和发展，临床应加以重视。
OBJECTIVE: To dynamically observe the changes of nailfold microcirculation induced by early urokinase (UK) thrombolytic therapy in patients with acute myocardial infarction (AMI) and to explore its possible mechanism, to provide theory for the treatment of AMI and the prevention of reperfusion injury (RI) in accordance with. Methods: The microsurgical video recording system combined with weighted integral method was used to investigate the microcirculation of nail polish in 21 AMI patients. Results: The blood flow deteriorated immediately after reperfusion (P <0.01). The incidence of reperfusion arrhythmia was related to the integral value of blood flow (P <0.05). Conclusions; 1, AMI early UK treatment with coronary recanalization, the characteristic changes of the microcirculation of Nailfold a high degree of aggregation of red blood cells, a large number of white micro-embolism that the deterioration of blood flow state. Tip fibrinolytic hyperthyroidism. Support AMI thrombolysis before and after the application of ASA, heparin and other anticoagulant therapy. 2, abnormal changes in micro-circulation Participate in the occurrence and development of AMI and RI, clinical should pay attention.