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血管成形术作为急性心肌梗死的早期血运重建治疗

Angioplasty as early revascularization in acute myocardial infarction.

作者信息

Koca Vedat, Ari Hasan

机构信息

1st Clinic of Cardiology, Bursa Subspecialization Training and Research Hospital, Bursa, Turkey.

出版信息

Anadolu Kardiyol Derg. 2008 Nov;8 Suppl 2:77-83.

Abstract

The clinical manifestations characterized by myocardial ischemia due to a sudden decrease in coronary artery flow are defined as "acute coronary syndromes". These syndromes are classified according to the presence of ST segment elevation on the electrocardiogram (ECG) and the presence of a Q wave. In ST-elevation myocardial infarction (STEMI), the lesion is usually located at the proximal part and the coronary occlusion is complete, myocardial loss is to a great extent, prognosis is poor, and the risk of developing cardiac failure and arrhythmias in the post infarction period is high. Considering these complications, it is obvious that the immediate provision of reperfusion by opening the completely occluded artery is of vital importance in patients with STEMI. However, a third of these patients are unable to receive reperfusion therapy on time A considerable number of patients can receive the treatment within 12 hours after the onset of symptoms at best. In cases arriving late, the effectiveness of reperfusion therapy decreases and the risk of mortality and morbidity increases.

摘要

以冠状动脉血流突然减少导致心肌缺血为特征的临床表现被定义为“急性冠状动脉综合征”。这些综合征根据心电图(ECG)上ST段抬高的存在情况以及Q波的存在情况进行分类。在ST段抬高型心肌梗死(STEMI)中,病变通常位于近端,冠状动脉闭塞完全,心肌损失程度大,预后差,梗死后期发生心力衰竭和心律失常的风险高。考虑到这些并发症,显然对于STEMI患者而言,立即通过开通完全闭塞的动脉进行再灌注至关重要。然而,这些患者中有三分之一无法及时接受再灌注治疗。相当数量的患者最多只能在症状发作后12小时内接受治疗。对于就诊较晚的病例,再灌注治疗的效果会降低,死亡和发病风险会增加。

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