天津医药 ›› 2017, Vol. 45 ›› Issue (11): 1135-1138.doi: 10.11958/20170928

• 专题-心肌梗死 • 上一篇    下一篇

STEMI合并多支血管病变的血运重建策略

赵冠棋,师树田,王晓,聂绍平   

  1. 首都医科大学附属北京安贞医院急诊危重症中心
  • 收稿日期:2017-08-25 修回日期:2017-09-06 出版日期:2017-11-15 发布日期:2017-11-15
  • 通讯作者: 聂绍平 E-mail:spnie@126.com
  • 基金资助:
    北京市医院管理局重点医学专业发展计划(ZYLX201710);北京市医院管理局科研培育计划(PX2016048);北京市医院管理局
    “青苗”计划(QML20160605)

Revascularization strategy for STEMI patients with multivessel disease

ZHAO Guan-qi, SHI Shu-tian, WANG Xiao, NIE Shao-ping   

  1. Emergency & Critical Care Center, Beijing Anzhen Hospital, Capital Medical University
  • Received:2017-08-25 Revised:2017-09-06 Published:2017-11-15 Online:2017-11-15

摘要: ST 段抬高型心肌梗死(STEMI)合并多支血管病变较为常见,且往往提示预后不良。在成功开通梗死相关血管后,直接 PCI (PPCI)时是否应同期处理非梗死相关血管一直存在争议。近年来,越来越多的证据提示,与仅处理梗死相关血管相比,对非梗死相关血管同期进行血运重建的患者预后较好。然而,有关非梗死相关血管的选择和处理时机仍然颇具争议。本文回顾了最新的临床证据,旨在为合并多支血管病变的 STEMI 患者的诊治提供思路。

关键词: ST段抬高型心肌梗死, 直接PCI, 多支血管病变, 非梗死相关血管, 血运重建

Abstract: ST-segment elevation myocardial infarction (STEMI) in patients with multivessel disease is a common situation, and suggests poor prognosis. After the reperfusion of infarct-related blood vessels in the primary PCI (PPCI), how to deal with the non-infarct related vessel has been a hot issue. In recent years, more and more evidence suggests that compared with treatment of infarct-related vessels only, revascularization of non-infarct related vessels will result in a better prognosis. But the timing and the choice of non-infarct-related vessel revascularization are still controversial. This article reviews the latest clinical evidence to improve the diagnosis and treatment of STEMI patients with multivessel disease.

Key words: ST-segment elevation myocardial infarction, primary PCI, multivessel disease, non-infarct related vessel, revascularization

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