【摘要】：背景:急性ST段抬高性心肌梗死(ST—elevation myocardial infarction,STEMI)是指心肌組織發(fā)生急性缺血壞死,大部分是在冠狀動(dòng)脈病變的基礎(chǔ)上由于冠狀動(dòng)脈血液供應(yīng)的急劇減少或中斷,導(dǎo)致心肌出現(xiàn)嚴(yán)重持續(xù)的缺血從而引發(fā)生心肌梗死。我國最近幾年來急性心肌梗死(acute myocardial infarction,AMI)發(fā)病率及死亡率持續(xù)升高,采用快速有效的再灌注治療策略能夠及時(shí)挽救患者生命和提高生存率,是治療急性ST段抬高型心肌梗死的關(guān)鍵。目的:通過綜述分析STEMI再灌注治療研究成果,為臨床上更好的治療急性心肌梗死提供參考,選擇最適合中國國情的再灌注策略。方法:進(jìn)行關(guān)鍵詞檢索,以“急性ST段抬高型心肌梗死、再灌注治療、溶栓、PCI、胸痛中心、區(qū)域協(xié)作救治”等為關(guān)鍵詞,找出急性STEMI再灌注治療策略的相關(guān)研究,同時(shí)對再灌注治療策略進(jìn)行總結(jié)。結(jié)果與結(jié)論:目前關(guān)于STEMI再灌注治療有最新的指南及大量相關(guān)文獻(xiàn)報(bào)道,綜合這些研究結(jié)果表明現(xiàn)對實(shí)施早期再灌注的時(shí)間要求越來越高,盡可能首選直接PCI。然而中國的實(shí)際情況與指南的要求有較大的差距,所以需要在結(jié)合國情的前提下強(qiáng)化藥物-介入治療策略,同時(shí)還要不斷加強(qiáng)區(qū)域協(xié)同體系的構(gòu)建力度。
[Abstract]:Background: acute St segment elevation myocardial infarction (ST-elevation myocardial segment elevation myocardial infarction) refers to acute ischemic necrosis of myocardial tissue, most of which are based on coronary artery disease due to a sharp decrease or interruption of coronary blood supply. Leading to severe and persistent myocardial ischemia, leading to myocardial infarction. In recent years, the incidence and mortality rate of acute myocardial infarction (acute myocardial) has been increasing in China. It is the key to treat acute ST-segment elevation myocardial infarction (AMI) that rapid and effective reperfusion therapy strategy can save patients' lives and improve survival rate in time. Objective: to summarize and analyze the research results of STEMI reperfusion therapy in order to provide reference for better clinical treatment of acute myocardial infarction and to select the most suitable reperfusion strategy for China. Methods: the key words were searched, such as "acute ST-segment elevation myocardial infarction, reperfusion therapy, thrombolytic therapy, chest pain center, regional cooperative treatment" as the key words to find out the relevant research of acute STEMI reperfusion therapy strategy. At the same time, the strategy of reperfusion therapy was summarized. Results & conclusion: at present, there are the latest guidelines and a large number of related literature reports on STEMI reperfusion therapy. These results show that the time requirement for early reperfusion is becoming higher and higher, and direct PCI is preferred as far as possible. However, there is a big gap between the actual situation of China and the requirements of the guidelines, so it is necessary to strengthen the strategy of drug-interventional therapy under the premise of combining with the national conditions, and at the same time, to strengthen the construction of regional synergistic system.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R542.22

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