Choudhury Tawfiq, West Nick Ej, El-Omar Magdi
Manchester Royal Infirmary, Manchester, UK.
Papworth Hospital, Cambridge, UK.
Clin Med (Lond). 2016 Jun;16(3):277-82. doi: 10.7861/clinmedicine.16-3-277.
ST segment elevation myocardial infarction remains a significant contributor to morbidity and mortality worldwide, despite a declining incidence and better survival rates. It usually results from thrombotic occlusion of a coronary artery at the site of a ruptured or eroded plaque. Diagnosis is based on characteristic symptoms and electrocardiogram changes, and confirmed subsequently by raised cardiac enzymes. Prognosis is dependent on the size of the infarct, presence of collaterals and speed with which the occluded artery is reopened. Mechanical reperfusion by primary percutaneous coronary intervention is superior to fibrinolytic therapy if delivered by an experienced team in a timely fashion. Post-reperfusion care includes monitoring for complications, evaluation of left ventricular function, secondary preventive therapy and cardiac rehabilitation.
尽管ST段抬高型心肌梗死的发病率在下降且生存率有所提高，但它仍然是全球发病和死亡的重要原因。它通常是由破裂或糜烂斑块部位的冠状动脉血栓性闭塞引起的。诊断基于特征性症状和心电图变化，随后通过心肌酶升高得以证实。预后取决于梗死面积、侧支循环的存在以及闭塞动脉重新开通的速度。如果由经验丰富的团队及时进行，通过直接经皮冠状动脉介入治疗进行机械再灌注优于纤溶治疗。再灌注后护理包括监测并发症、评估左心室功能、二级预防治疗和心脏康复。
