The Status of Thrombolytic Therapy in Treatment of ST-segment Elevation Myocardial Infarction
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摘要: 急性ST段抬高型心肌梗死的再灌注治疗中, 溶栓治疗作为解决这一血栓性疾病的治疗方式, 仍应具有相当重要的地位。近些年溶栓治疗用于心肌梗死治疗的相关临床研究已分别证实:(1)在发病时间较早且介入开始时间可能延误较长(>2 h)的情况下考虑首选; (2)在拟采取介入治疗但因有一些延误时(1 h)考虑使用低剂量溶栓药物辅助溶栓后再行介入治疗; (3)在冠状动脉内血栓负荷严重时冠状动脉内使用溶栓药物再行介入治疗, 以上3种情况临床应用时应予以充分考虑。
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关键词:
- ST段抬高型心肌梗死 /
- 溶栓治疗 /
- 介入治疗
Abstract: Thrombolytic revascularization therapy still remains an important method in the treatment of ST-segment elevation myocardial infarction (STEMI). Recent clinical studies confirmed the status of thrombolytic therapy in 3 clinical situations:estimated long delay(>2 hours) in primary percutaneous coronary intervention (PCI), pharmco-invasive thrombolytic therapy with estimated PCI delay(1 hour), a large thrombus treated with intra-coronary use of low dose thrombolytic therapy during primary PCI. Above 3 conditions should be fully considered during clinical application.利益冲突 无 -
[1] Morrison LJ, Verbeek PR, McDonald AC, et al. Mortality and prehospital thrombolysis for acute myocardial infarction:A meta-analysis[J]. JAMA, 2000, 283:2686-2692 doi: 10.1001/jama.283.20.2686 [2] Vora AN, Holmes DN, Rokos I, et al. Fibrinolysis use among patients requiring interhospital transfer for ST-segment elevation myocardial infarction care:a report from the US National Cardiovascular Data Registry[J]. JAMA Inter Med, 2015, 175:207-215. doi: 10.1001/jamainternmed.2014.6573 [3] Widimsk P, Budesinsk T, Vorac D, et al. Long distance transport for primary angioplasty vs immediate thrombolysis in acute myocardial infarction:Final results of the randomized national multi-centre trial-PRAGUE-2[J]. EUR Heart J, 2003, 24:94-1-4. https://academic.oup.com/eurheartj/article/24/19/1798/495182 [4] O'Gara PT, Kushner FG, Ascheim DD, et al.2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction:a report of the American College of cardiology Foundation/American Heart Association Task Force on Practice Guidelines[J]. J Am Coll Cardiol, 2013, 61:e78-e140. https://pubmed.ncbi.nlm.nih.gov/23256914/ [5] 中华医学会心血管病学分会, 中华心血管病杂志编委会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志, 2015, 43:380-393. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhxxgb201008002 [6] Assessment of the Saftety and Efficacy of a New Treatment Strategy with Percutaneous Coronary Intervention(ASSENT-4 PCI) investigators. Primary versus tenecteplase-facilitated percutaneous coronary intervention in patients with ST-segment elevation acute myocardial infraction(ASSENT-4 PCI):randomised trial[J]. Lancet, 2006, 367:569-578. doi: 10.1016/S0140-6736(06)68147-6 [7] Ellis SG, Tendera M, de Belder MA, et al. 1-year survial in a randomized trial of facilitated reperfusion:results from the FINESSE(Facilitated Intervention with enhanced reperfu-sion speed to stop Events) trial[J].JACC Cardiovasc Interv, 2009, 2:909-916. doi: 10.1016/j.jcin.2009.07.009 [8] Armstrong PW, Gershlick AH, Goldstein P, et al. Fibrinolysis or primary PCI in ST-segment elevation myocardial infarction[J]. N Engl J Med, 2013, 368:1379-1387. doi: 10.1056/NEJMoa1301092 [9] Han YL, Liu JN, Jing QM, et al. The efficacy and safety of pharmacoinvasive therapy with prourokinase for acute ST-segment elevation myocardial infarction patients with expected long percutaneous coronary intervention delay[J]. Cardiolvasc Ther, 2013, 31:285-290. doi: 10.1111/1755-5922.12020 [10] Pu J, Ding S, Ge H, et al. Efficacy and safety of a pharmaco-invasive strategy with half-dose alteplase versus primary angioplasty in ST segment-elevation myocardial infarction:EARLY-MYO trial(early routine catheterization after alteplase fibrinolysis versus primary PCI in acute ST segment elevation myocardial infarction)[J]. Circulation, 2017, 136:1462-1473. doi: 10.1161/CIRCULATIONAHA.117.030582 [11] Kelly RV, Crouch E, Krumnacher H, et al. Safety of adjunctive intracoronary thrombolytic therapy during complex percutaneous coronary intervention:initial experience with intracoronary tenecteplase[J]. Cathet Cardiovasc Interv, 2005, 66:327-332. doi: 10.1002/ccd.20521 [12] Boscarelli D, Vaquerinzo B, Miranda-Guardiola F, et al. Intracoronary thrombolysis in patients with ST-segment elevation myocardial infarction presenting with massive intraluminal thrombus and failed aspiration[J]. Eur Heart J Acute Cardiovasc Care, 2014, 3:229-236. doi: 10.1177/2048872614527008
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