急性ST段抬高型心肌梗死再灌注治疗的研究进展

发布时间：2018-07-31 14:59

【摘要】：背景:急性ST段抬高性心肌梗死(ST—elevation myocardial infarction,STEMI)是指心肌组织发生急性缺血坏死,大部分是在冠状动脉病变的基础上由于冠状动脉血液供应的急剧减少或中断,导致心肌出现严重持续的缺血从而引发生心肌梗死。我国最近几年来急性心肌梗死(acute myocardial infarction,AMI)发病率及死亡率持续升高,采用快速有效的再灌注治疗策略能够及时挽救患者生命和提高生存率,是治疗急性ST段抬高型心肌梗死的关键。目的:通过综述分析STEMI再灌注治疗研究成果,为临床上更好的治疗急性心肌梗死提供参考,选择最适合中国国情的再灌注策略。方法:进行关键词检索,以“急性ST段抬高型心肌梗死、再灌注治疗、溶栓、PCI、胸痛中心、区域协作救治”等为关键词,找出急性STEMI再灌注治疗策略的相关研究,同时对再灌注治疗策略进行总结。结果与结论:目前关于STEMI再灌注治疗有最新的指南及大量相关文献报道,综合这些研究结果表明现对实施早期再灌注的时间要求越来越高,尽可能首选直接PCI。然而中国的实际情况与指南的要求有较大的差距,所以需要在结合国情的前提下强化药物-介入治疗策略,同时还要不断加强区域协同体系的构建力度。
[Abstract]:Background: acute St segment elevation myocardial infarction (ST-elevation myocardial segment elevation myocardial infarction) refers to acute ischemic necrosis of myocardial tissue, most of which are based on coronary artery disease due to a sharp decrease or interruption of coronary blood supply. Leading to severe and persistent myocardial ischemia, leading to myocardial infarction. In recent years, the incidence and mortality rate of acute myocardial infarction (acute myocardial) has been increasing in China. It is the key to treat acute ST-segment elevation myocardial infarction (AMI) that rapid and effective reperfusion therapy strategy can save patients' lives and improve survival rate in time. Objective: to summarize and analyze the research results of STEMI reperfusion therapy in order to provide reference for better clinical treatment of acute myocardial infarction and to select the most suitable reperfusion strategy for China. Methods: the key words were searched, such as "acute ST-segment elevation myocardial infarction, reperfusion therapy, thrombolytic therapy, chest pain center, regional cooperative treatment" as the key words to find out the relevant research of acute STEMI reperfusion therapy strategy. At the same time, the strategy of reperfusion therapy was summarized. Results & conclusion: at present, there are the latest guidelines and a large number of related literature reports on STEMI reperfusion therapy. These results show that the time requirement for early reperfusion is becoming higher and higher, and direct PCI is preferred as far as possible. However, there is a big gap between the actual situation of China and the requirements of the guidelines, so it is necessary to strengthen the strategy of drug-interventional therapy under the premise of combining with the national conditions, and at the same time, to strengthen the construction of regional synergistic system.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R542.22

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