急性心肌梗死合并心源性休克热点问题的探讨

Discussion on hot issues in acute myocardial infarction complicated with cardiogenic shock

心源性休克(CS)被定义为由于心输出量减少导致重要器官低灌注的一种状态。急性心肌梗死(AMI)是CS最主要的原因。AMI合并CS患者死亡率高,接受早期血运重建可以降低死亡率,使患者受益。AMI治疗指南提出,合并CS患者无论发病时间长短,建议急诊血管再灌注治疗,可选择经皮冠状动脉介入治疗(PCI)或者冠状动脉搭桥术(CABG)。血管活性药物、主动脉内球囊反搏等机械循环辅助装置也广泛应用于CS患者。

Cardiogenic shock(CS)is defined as a state of critical tissue hypoperfusion and endorgan failure because of reduced cardiac output.Acute myocardial infarction(AMI)is a prominent cause of CS.Despite advances in interventional and medical treatment,CS remains the leading cause of death in AMI.Early revascularization can reduce the mortality.The guideline for primary percutaneous coronary intervention(PCI)indicates that emergency revascularization is recommended in suitable patients with cardiogenic shock due to pump failure after AMI regardless of the duration of the disease.The type of revascularization,either PCI or coronary artery bypass grafting(CABG),might the optimal treatment strategy.The use of mechanical circulatory support devices appears to provide temporary circulatory support for patients with CS.