急性心肌梗死再灌注治疗的研究进展

Research Progress of Acute Myocardial Infarction Reperfusion Therapy

急性心肌梗死是指因持久而严重的心肌缺血导致的部分心肌急性坏死。再灌注治疗可迅速恢复冠状动脉血流供应,保证心肌的血流灌注,降低病死率。再灌注治疗方法包括静脉溶栓治疗、经皮冠状动脉介入(PCI)治疗等,溶栓药物已从第一代药物尿激酶、链激酶等,发展到第二代重组组织型纤溶酶原激活剂及第三代基因重组组织型纤溶酶原激活剂变异体;PCI治疗包括直接PCI、补救PCI及择期PCI。了解溶栓、冠状动脉介入治疗的适应证、疗效以及优缺点可为急性心肌梗死患者选择合理的治疗方法提供参考。

Acute myocardial infarction refers to acute myocardial necrosis due to persistent and severe myocardial ischemia. Reperfusion therapy can quickly restore the coronary blood supply,ensure myocardial perfusion and reduce mortality. Reperfusion therapy includes intravenous thrombolytic therapy,percutaneous coronary intervention（ PCI） etc. Thrombolytic drugs have evolved from first-generation drugs such as urokinase and streptokinase to second-generation recombinant tissue-type plasminogen activators and third-generation gene recombinant tissue plasminogen activator variants. PCI includes primary PCI,remedial PCI,and elective PCI. Understanding the indication,curative effect,advantages and disadvantages of thrombolytic therapy and PCI could provide references for selecting reasonable treatments.