Kimura Kazuo, Kosuge Masami
The Division of Cardiology, Yokohama City University Medical Center.
Nihon Rinsho. 2006 Apr;64(4):701-8.
The reperfusion therapy including both fibrinolytic therapy and primary percutaneous coronary intervention (PCI) has been established in patients with ST-segment elevation acute myocardial infarction (STEMI). Fibrinolysis has the advantage of universal availability and short time to administration. Because the benefit of fibrinolysis is directly related to the time from symptom onset to treatment as demonstrated in many studies, every effort must be made to minimize any delays between symptom onset and the initiation of a safe and effective reperfusion strategy in patients with STEMI. Although the benefit of fibrinolysis is limited by inadequate reperfusion or reocclusion of the infarct-related artery in a sizable portion of patients, fibrinolysis followed by planned PCI can be one of approaches in patients presenting within 2 or 3 hours from onset of STEMI.
再灌注治疗，包括溶栓治疗和直接经皮冠状动脉介入治疗（PCI），已在ST段抬高型急性心肌梗死（STEMI）患者中确立。溶栓具有普遍可及性和给药时间短的优势。正如许多研究所示，溶栓的益处与症状发作到治疗的时间直接相关，因此必须尽一切努力尽量减少STEMI患者症状发作与启动安全有效的再灌注策略之间的任何延迟。尽管在相当一部分患者中，溶栓的益处受到梗死相关动脉再灌注不足或再闭塞的限制，但对于STEMI发作后2或3小时内就诊的患者，溶栓后行计划性PCI可能是治疗方法之一。
