急性心肌梗死优化介入再灌注治疗的临床研究进展

Clinical Study Advances of Optimized Interventive Reperfusion Therapy of Acute Myocardial Infarction

急性心肌梗死急诊直接介入治疗是目前首选的措施,但仍有部分患者不能获得良好的心肌再灌注,因此,如何使患者获得良好的心肌灌注成为临床医师关注的焦点。微循环血栓栓塞、微循环炎症水肿、微循环血管痉挛等因素所造成的冠状动脉微循环障碍是心肌灌注不良的主要机制。抗血小板治疗、抗炎治疗及血栓抽吸等联合治疗可有效改善冠状动脉微循环功能,降低无复流和慢血流的发生率,改善心肌再灌注。

The primary percutaneous coronary intervention ( PPCI) is an optimal choice for acute myocardial infarction . But,some patients cannot obtain good coronary blood reperfusion ,which has become the focus of the doctors in clinical . Microcirculation thrombus embolism ,inflammation and edema ,microvascular spasm caused coronary microcirculation disor-der is the major mechanism of the insufficient reflow after PPCI .Anti-platelet medicines , anti-inflammation therapy and adjunctive thrombus aspiration ( TA ) can improve coronary microvascular function , lower the rate of no-reflow or slow reflow,and enhance the effect of PPCI .