天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (11): 1141-1144.doi: 10.11958/20170913

• 专题-心肌梗死 • 上一篇    下一篇

急性ST段抬高性心肌梗死合并多支血管病变的血运重建策略进展

戴宇翔，钱菊英   

  1. 复旦大学附属中山医院心内科，上海市心血管病研究所
  • 收稿日期:2017-08-18 修回日期:2017-09-26 出版日期:2017-11-15 发布日期:2017-11-15
  • 通讯作者: 钱菊英 E-mail:qian.juying@zs-hospital.sh.cn
  • 基金资助:
    国家自然科学基金青年科学基金项目（81300095）

Progress in revascularization strategy of ST-segment elevation myocardial infarction with multiple vessel disease#br#

DAI Yu-xiang, QIAN Ju-ying #br#   

  1. Department of Cardiology, the Affiliated Zhongshan Hospital, Fudan University
  • Received:2017-08-18 Revised:2017-09-26 Published:2017-11-15 Online:2017-11-15

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摘要： 急性 ST 段抬高型心肌梗死（STEMI）是冠心病最严重的临床类型，占急性心肌梗死（AMI）的 25%~40%，其治疗的关键是恢复梗死区域的心肌灌注、挽救濒临死亡的心肌、缩小梗死面积。大约 41%~67% 的 STEMI 患者同时存在有临床缺血意义的多支血管病变（MVD），与单支血管病变相比，MVD 患者临床预后更差，对于该类患者，选择何种血运重建策略，是单纯开通梗死相关血管（IRA-PCI），还是同时对多支血管完全血运重建（MV-PCI），以及血运重建的时机如何选择，一直是急诊介入治疗领域存在争议的一个话题。目前，针对合并 MVD 的 STEMI 血运重建策略的研究不断进行，临床研究结果的相继公布亦推动了指南和治疗策略的不断更新。

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

Abstract: ST-segment elevation myocardial infarction (STEMI) is the most serious type of coronary heart disease,accounting for 25% to 40% of acute myocardial infarction (AMI). The key to treat STEMI is to restore myocardial perfusion in the infarct area, to rescue the ischemic myocardium, and to reduce the size of infarction. About 41% to 67% of patients with STEMI have multiple vascular disease (MVD). Compared with single vessel disease, the clinical outcome of MVD is worse. In these patients, it still remains a controversial topic in emergency interventions for STEMI patients, the infarct-related artery only revascularization or multi-vessel revascularization, and the timing of revascularization. The clinical studies of revascularization strategy for MVD in STEMI patients have been ongoing, and the results have also led to the continuous updating of guidelines and treatment strategies.

Key words: myocardial infarction, acute ST-segment elevation myocardial infarction, multiple vascular disease;revascularization, infarction related artery

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