伴有冠状动脉完全闭塞的急性非ST段抬高型心肌梗死研究进展

Progress in the study of acute non-ST segment elevation myocardial infarction with the totally occluded coronary artery

在心电生理学中,通常认为发生急性非ST段抬高型心肌梗死(NSTEMI)的患者,其罪犯血管没有发生完全闭塞(TOCA),但在临床实践中,部分通过心电图诊断的NSTEMI患者的冠状动脉造影结果存在冠状动脉完全闭塞。目前,国内并无针对NSTEMI患者伴有TOCA的诊疗建议,使TOCA血管闭塞时间长,心肌损伤时间延长,从而导致未及时解决NSTEMI合并TOCA相关患者的生活质量及长期预后明显较差。本文旨在对伴有TOCA的NSTEMI患者的流行病学、机制原因、风险预后及危险因素的研究进展进行综述。

In cardiac electrophysiology,it is commonly suggested that in the patients with non-ST elevation myocardial infarction(NSTEMI)the culprit vessel has not developed total occlusion.however,in the clinical practice,the results of coronary angiography in some patients with NSTEMI diagnosed by electrocardiography indicate the presence of total occluded coronary artery(TOCA).At present,there are no treatment recommendations for NSTEMI patients with TOCA in China,which leads to prolonged occlusion of TOCA vessels and prolonged myocardial injury,thus leading to an delayed resolution of the quality of life of NSTEMI patients combined with TOCA,which is visible in their significantly poorer long-term prognosis.The paper reviews the progress of research on the epidemiology,mechanisms and etiology,risk prognosis and risk factors of NSTEMI patients with TOCA.