急性ST段抬高型心肌梗塞的治疗进展

Progress in the Treatment of Acute ST-segment Elevation Myocardial Infarction

研究急性ST段抬高型心肌梗塞的治疗进展,为日后治疗该病症提供系统化治疗对策。急性ST段抬高型心肌梗塞是急性冠脉综合征中死亡率最高的疾病,经过几十年的研究和发展,其治疗成功率取得了斐然成绩,但该病症仍然是心肌梗塞患者死亡的一大因素。在对急性ST段抬高型心肌梗塞患者的治疗中,应采取早发现、早治疗的原则,抓住12~24 h的治疗时机,对患者进行经皮冠状动脉介入治疗(PCI)策略。另一方面,虽然诊断的金标准是血肌钙蛋白指标,但只要心电图提示有明显的心肌缺血,则应及时治疗,而不要等待肌钙蛋白结果之后再进行治疗。同时,在入院前的救护车上,医务人员应对心肌梗塞相关的血栓问题进行预处理,以便入院后更早的采取经皮冠状动脉介入治疗策略。若患者已达到治疗条件,则应选择溶栓治疗方式,以挽救患者生命。

The study researches the treatment progress of acute ST-segment elevation myocardial infarction,to provide systematic treatment countermeasures for the disease.The mortality of acute ST-segment elevation myocardial infarction is the highest in acute coronary syndrome.Through decades of research and development,there are great achievements in the treatment,but the disease is still one of the death causes of myocardial infarction.In the treatment of acute ST-segment elevation myocardial infarction,it is necessary to adopt the principle of early finding and treatment,grasp the opportunity of 12~24 h treatment,and CPI strategy.Although troponin index is the gold standard,it is necessary to treat in time when ECG hints obvious myocardial ischemia instead of the treatment after troponin results.Meanwhile,in the ambulance before admission,medical staff should preprocess thrombus issues related with myocardial infarction so that earlier PCI can be adopted after admission.If patients need to be treated,thrombolytic therapy should be adopted to save life.