急性ST段抬高型心肌梗死后支架置入时机的研究进展

The Timing of Stent Implantation for Acute ST Segment Elevation Myocardial Infarction

急诊经皮冠状动脉介入治疗是急性ST段抬高型心肌梗死患者救治的关键措施,立即支架置入是目前开通血管、恢复血流常用的介入方法,但存在微循环栓塞及无复流的现象,严重影响预后。延迟支架置入(DSI)联合强化抗栓治疗,可减轻冠状动脉血栓负荷,降低微循环障碍的发生率,改善患者的心脏功能及预后。但多项随机对照试验结果并未显示出DSI的明显获益,因此临床上对于DSI的应用仍存在争议。现对急性ST段抬高型心肌梗死患者支架置入时机进行综述,从而为临床工作提供参考。

Emergency percutaneous coronary intervention is the key treatment for patients with acute ST segment elevation myocardial infarction.Immediate stent implantation is a commonly used interventional method to open blood vessels and restore blood flow,but there are microcirculation embolism and no reflow phenomenon,which seriously affect the prognosis.Delayed stent implantation(DSI)combined with enhanced antithrombotic therapy can reduce the burden of coronary thrombosis and the incidence of microcirculation disorders,and improve the cardiac function and prognosis of patients.However,many randomized controlled trials did not show significant benefits of DSI.Therefore,the clinical application of DSI is still controversial.This article will review the timing of stent implantation in patients with acute ST segment elevation myocardial infarction,so as to provide reference for clinical work.