To clarify several scientific issues of thrombolytic therapy for ST segment elevation myocardial infarction
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摘要: 本文厘清了有关溶栓治疗在ST段抬高型心肌梗死(STEMI)中作用的几个重要科学问题，并提出在中国大量新发STEMI患者无法及时直接经皮冠状动脉介入(PCI)治疗的背景下，可采用灵活先溶栓后PCI策略应对现实世界中复杂的工作环境。在使用新型溶栓药物的条件下，半剂量溶栓3 h后行PCI安全可行，且溶栓后PCI的效果不劣于直接PCI。因此，先溶栓后PCI的“药物介入策略”可能是STEMI患者理想的选择。
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关键词:
- ST段抬高型心肌梗死 /
- 溶栓 /
- 经皮冠状动脉介入
Abstract: Several important scientific questions about the role of thrombolysis in STEMI are raised and discussed in detail. In the context of a large number of new STEMI patients in China who cannot receive timely direct PCI treatment, a flexible strategy of thrombolysis followed by PCI can be used to respond to complex working conditions in the real world. Studies have shown that under the conditions of using new thrombolytic agents, half-dose thrombolysis followed by PCI after 3 hours is safe and feasible. The effect of post-thrombolysis PCI is not inferior to direct PCI. Therefore, the "pharmaco-invasive strategy" of first thrombolysis followed by PCI may be an ideal choice for STEMI patients. -
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