ST段抬高型心肌梗死诊疗策略的临床观察

Clinical Observation on Strategy of Diagnosis and Treatment of ST-elevation Myocardial Infarction

目的:比较2004年与2010年ST段抬高型心肌梗死(STEMI)诊疗策略的变化,分析其与指南的差距。方法:回顾性研究152例STEMI患者(2004年37例,2010年115例)临床资料,对比分析其住院期间诊断治疗策略的差异并了解其与指南差距。结论:STEMI患者近6年来住院诊疗策略进步明显,尤其是有创检查及治疗部分,但临床实践与循证指南仍存在不少差距,特别是GPⅡb/Ⅲa抑制剂使用、早期再灌注治疗上仍有待提高。

Objective： To compare the strategy of diagnosis and treatment of patients with ST elevation myocardial infarction （STEMI）between 2004 and 2010, and to analyze the gap between evidence-based guideline and clinical practice. Methocls Clinical data of 152 patients with STEMI （37 cases in 2004, 115 cases in 2010） were studied retrospectively, the differences of strategy of diagnosis and treatment in hospital were analyzed and compared with that of guideline. Conclusions.. There were great progresses in the diagnosis and management of patients with STEMI in recent 6 years, especially in respect of invasive examinations and treatments, but there were still some gaps between clinical practice and evidence-based guideline, especially the use of GP Ⅱ b/Ⅲa inhibitors, and early reperfusion therapy still have to be improved.