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溶栓技术在ST段抬高型心肌梗死救治中的地位

沈珠军

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文章导航 > 协和医学杂志  > 2020 >  11(2): 127-129
沈珠军. 溶栓技术在ST段抬高型心肌梗死救治中的地位[J]. 协和医学杂志, 2020, 11(2): 127-129. doi: 10.3969/j.issn.1674-9081.20190265
引用本文: 沈珠军. 溶栓技术在ST段抬高型心肌梗死救治中的地位[J]. 协和医学杂志, 2020, 11(2): 127-129. doi: 10.3969/j.issn.1674-9081.20190265
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Zhu-jun SHEN. The Status of Thrombolytic Therapy in Treatment of ST-segment Elevation Myocardial Infarction[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(2): 127-129. doi: 10.3969/j.issn.1674-9081.20190265
Citation: Zhu-jun SHEN. The Status of Thrombolytic Therapy in Treatment of ST-segment Elevation Myocardial Infarction[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(2): 127-129. doi: 10.3969/j.issn.1674-9081.20190265
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溶栓技术在ST段抬高型心肌梗死救治中的地位

doi: 10.3969/j.issn.1674-9081.20190265

  • 中国医学科学院 北京协和医学院 北京协和医院心内科, 北京 100730

详细信息
    作者简介:

    沈珠军：电话:010-69155066, E-mail:zhujun66shen@126.com

  • 中图分类号: R542.2+2;R45;R-1

The Status of Thrombolytic Therapy in Treatment of ST-segment Elevation Myocardial Infarction

  • Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

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    摘要
  • 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。
    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.
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    • 参考文献(12)
  • [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
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    [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
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出版历程
  • 收稿日期:  2019-12-02
  • 刊出日期:  2020-03-30

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