急性ST段抬高型心肌梗死溶栓治疗的最新进展

Latest development of thrombolytic therapy for patients with acute STelevation myocardial infarction

经皮冠状动脉介入(PCI)已经成为普遍接受的治疗急性ST段抬高型心肌梗死(STEMI)的首选方案。但是,由于人才、技术、设备等条件的限制,急诊PCI仍不能普及或及时。近年来,随着药物的改进和更新,溶栓的治疗效果不断进步,使其成为基层再灌注治疗的一个不可或缺的手段。溶栓治疗实施的越早,其治疗获益就越大。根据实际情况因地制宜的选择合适的溶栓方案及溶栓药物对于改善STEMI患者的预后大有裨益。本文将对现有溶栓药物的特点,及其优劣进行综述,以期获得最合理的利用。

Percutaneous coronary intervention(PCI) has become the preferred treatment for patients with acute ST-elevation myocardial infarction(STEMI).However,emergency PCI still could not be popularized or timely performed because of the limitation of talents,technology and equipments.Thrombolytic therapy improves the clinical efficacy of patients with acute ST-elevation myocardial infarction,which has become an indispensable means of primary reperfusion therapy.The earlier the thrombolytic therapy is performed,the greater the benefits are for the patients.It is of great benefit to choose the appropriate reperfusion strategy for patients with acute ST-segment elevation myocardial infarction under specific conditions.We will summarize the advantages and disadvantages of various thrombolytic drugs in this paper for the most rational choice of the fibrinolytic strategy and thrombolytic drugs.