中国冠心病介入治疗发展现状:ST段抬高心肌梗死救治及胸痛中心建设

Development status of intervention therapy for coronary heart disease in China:ST segment elevation myocardial infarction and chest pain center

ST段抬高心肌梗死(ST segment elevation myocardial infarction,STEMI)是死亡率最高的冠心病类型,对该病的救治水平既能体现心血管内科专科救治能力,也是反映急救体系救治效率的最客观指标。20世纪末至21世纪初,我国STEMI患者的院内死亡率长期维持在10.1%~12.4%。2011年通过创建区域协同救治型胸痛中心模式显著提高了救治效率,经过10年努力,目前全国已有4700多家医院建立了胸痛中心,其中1672家胸痛中心通过认证。胸痛中心建设使STEMI患者的院内死亡率降至3%~4%,院内心力衰竭发生率从18.0%~24.7%降至14.2%。本文概略介绍过去10年我国胸痛中心所推动的急救体系建设、STEMI再灌注治疗策略及急诊介入技术方面的变化和发展。

ST segment elevation myocardial infarction(STEMI)is the most mortal type of coronary heart disease.The inhospital mortality of STEMI is the reflect of the cardiovascular professional ability as well as the efficiency of the regional emergence medical system.In the two decades of 1990s and 2000s,the in-hospital mortality of STEMI was maintained at 10.1%~12.4% in China,which was much higher than that in developed countries.The 1st chest pain center based on regional cooperative network was established in 2011 in China.After 10 years of popularization,the number of chest pain centers increased to above 4700 and 1672 of them were accredited by the end of 2020.The development of chest pain centers promoted the decrease of the in-hospital mortality of STEMI to 3%~4% and in-hospital heart failure decreased from 18.0%~24.7% to 14.2%.This article briefly introduced the development process of emergency medical system,the changes of reperfusion strategies of STEMI and the related technical potencies of primary percutaneous coronary intervention promoted by the development of chest pain centers in the latest 10 years in China.