Yamamoto Takeshi, Takano Teruo
Division of Intensive and Coronary Care Unit, Nippon Medical School.
Nihon Rinsho. 2006 Apr;64(4):617-23.
As the pathogenesis of acute coronary syndromes (ACS) has been well increasingly defined, there has been enormous progress in the diagnosis and treatment of ACS during the past 50 years. The previous terminology referring to the heterogeneity of the disease has shifted toward a unifying concept encompassing the wide spectrum of manifestations of ACS, subdivided for the purpose of therapeutic considerations into ST elevation myocardial infarction (MI), and non ST elevation ACS with or without cell necrosis (utilizing troponins), namely non ST elevation MI or unstable angina. The advent of coronary care units and the results of randomized clinical trials on reperfusion therapy, thrombolysis or percutaneous coronary intervention, and medical treatment with various pharmacological agents have substantially changed the therapeutic approach, and decreased in-hospital mortality.
随着急性冠状动脉综合征（ACS）的发病机制日益明确，在过去50年里，ACS的诊断和治疗取得了巨大进展。先前用于描述该疾病异质性的术语已转向一个统一的概念，涵盖了ACS的广泛表现形式，出于治疗考虑将其细分为ST段抬高型心肌梗死（MI）以及伴有或不伴有细胞坏死（利用肌钙蛋白）的非ST段抬高型ACS，即非ST段抬高型MI或不稳定型心绞痛。冠心病监护病房的出现以及关于再灌注治疗、溶栓或经皮冠状动脉介入治疗以及使用各种药物进行药物治疗的随机临床试验结果，极大地改变了治疗方法，并降低了住院死亡率。
