溶栓治疗的ST段抬高型心肌梗死患者急性期抗栓实践

Antithrombotic therapy in ST segment elevation myocardial infarction patients receiving thrombolysis at acute phase

溶栓治疗的同时也会诱发血栓形成,抗凝和抗血小板药物能够有效减轻药物溶栓后短期内冠状动脉血栓负荷的增加,改善ST段抬高型心肌梗死患者临床预后。如何选择有效的抗栓治疗策略,降低患者缺血性事件风险的同时不增加出血风险,达到最大的临床净获益,这是临床医生采用药物溶栓或溶栓结合早期经皮冠状动脉介入治疗策略时面临的重要挑战。本文简要分析溶栓治疗期间抗栓治疗的相关临床证据,为临床实践提供参考。

Thrombolysis can induce thrombosis,and anticoagulant and antiplatelet agents could effectively reduce the increased burden of coronary thrombosis by thrombolytics and improve the prognosis of patients presenting with ST segment elevation myocardial infarction.How to optimize antithrombotic strategy to achieve maximum net benefit by reducing risk in thrombotic events without increase in bleeding remains clinically challenging for clinicians to treat patients receiving thrombolytic agents with or without early percutaneous coronary intervention for reperfusion.We sought to discuss the clinical evidences on antithrombotic treatment in patients with thrombolysis and expect to provide useful information for clinical practice.