Uriel Nir, Moravsky Gil, Blatt Alex, Vered Zvi, Krakover Ricardo, Kaluski Edo
Cardiology Department, Assaf Harofeh Medical Center, Zerifin, Sackler Faculty of Medicine, Tel Aviv University, Israel.
Harefuah. 2006 May;145(5):367-70, 397, 396.
ST elevation myocardial infarction continues to be a major medical problem even in the beginning of the 21st century. Treatment guidelines for these patients are based on multiple randomized clinical trials. In order to minimize myocardial damage, early patency of the infarct relating artery must be accomplished. This is the major difference in the treatment strategy between ST elevation myocardial infarction and other acute coronary syndromes. Primary percutaneous coronary intervention and fibrinolysis are the two treatment modalities for achieving myocardial reperfusion. The subgroup of ST elevation myocardial infarction with spontaneous coronary artery reperfusion carries a more favorable prognosis. This review addresses the clinical characteristics, natural history, prognosis and treatment strategies for this group, with special emphasis on the optimal timing for revascularization, and the role of glycoprotein IIb/IIIa inhibitors.
即使在21世纪初，ST段抬高型心肌梗死仍然是一个主要的医学问题。这些患者的治疗指南基于多项随机临床试验。为了将心肌损伤降至最低，必须实现梗死相关动脉的早期通畅。这是ST段抬高型心肌梗死与其他急性冠状动脉综合征治疗策略的主要区别。直接经皮冠状动脉介入治疗和溶栓是实现心肌再灌注的两种治疗方式。ST段抬高型心肌梗死伴自发冠状动脉再灌注亚组的预后更有利。本综述阐述了该组患者的临床特征、自然病史、预后及治疗策略，特别强调了血运重建的最佳时机以及糖蛋白IIb/IIIa抑制剂的作用。
