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急性心肌梗塞延迟溶栓治疗（症状出现后６～２４小时）是溶栓疗法中有争议的问题之一。本文随机将１４只杂种家犬分成溶栓组及对照组，每组７只，在冠状动脉左前降支下１／３交界处游离冠状动脉约１．０厘米，用电刺激器刺激冠状动脉外膜，使其血管内形成血栓。对照组血栓形成后２４小时处死，取心肌行病理学及组织学检查；实验组血栓形成１０小时行冠状动脉内溶栓治疗（尿激酶１万ｕ／ｋｇ），血栓形成后２４小时处死。取心肌行病理学及组织学检查。实验动物在冠状动脉血栓形成前后、溶栓前后，均行肺毛细血管楔嵌压及心输出量测定、冠状动脉造影。结果：实验组７例冠状动脉阻塞有６例溶栓后再通而对照组中无１例再通；②溶栓后心输出量（３．４９±０．７２）与溶栓前（２．７７±０．５８）及未溶栓组（２．８１±０．３０）相比显著增加（ｐ＜０．０５）；③溶栓后梗塞心肌的重量（０．７８％）与对照组（１０．３％）相比明显下降。结论：延迟溶栓可以使闭塞的血管再通，与不溶栓相比可以明显提高心输出量及减少梗塞心肌的面积。本文提示，至少可以将急性心肌梗塞溶栓治疗的时间延迟到症状出现后１０小时。
Delayed thrombolysis in acute myocardial infarction (6 to 24 hours after symptom onset) is one of the most controversial issues in thrombolytic therapy. In this paper, 14 hybrid domestic dogs were randomly divided into thrombolytic group and control group, each group of 7, in the left anterior descending artery less than 1/3 junction of the free coronary artery about 1.0 cm, stimulated with electrical stimulator outside the coronary artery Membrane, the blood vessels to form thrombus. The control group was sacrificed at 24 hours after thrombosis. Pathological and histological examinations were performed on the myocardium. The thrombosis in the experimental group was treated by coronary thrombolysis (urokinase 10,000 u / kg) 10 hours after thrombosis. The rats were sacrificed at 24 hours after thrombosis. Take myocardial pathology and histological examination. Before and after the establishment of coronary thrombosis in experimental animals, thrombolysis before and after thrombolysis, pulmonary capillary wedge pressure and cardiac output were measured, coronary angiography. Results: In the experimental group, there were 6 cases of coronary artery occlusion in the experimental group and no recanalization in the control group after recanalization. The cardiac output (3.49 ± 0.72) and thrombolysis before thrombolysis (2. (P <0.05); ③The weight of infarcted myocardium after thrombolysis (0.78%) was significantly higher than that of control group (77 ± 0.58) and no thrombolysis group (2.81 ± 0.30) 10.3%) compared to significantly decreased. Conclusion: Delayed thrombolysis can make the recanalization of occluded blood vessels, which can obviously improve the cardiac output and the area of infarcted myocardium compared with that of non-thrombolysis. This article suggests that at least 10 minutes after symptom onset can be delayed by thrombolytic therapy in patients with acute myocardial infarction.