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ST elevation myocardial infarction

心血管

关键词心血管 疾病 心肌梗死

词汇介绍

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解析

elevation 英 /,elɪ'veɪʃ(ə)n/  美 /,ɛlɪ'veʃən/

释    义   抬高,海拔,标高,高度

例    句   Objective: To observe the clinical effect and safety in treatment of non-ST elevation myocardial infarction (NSTEMI) with clopidogrel. 目的 观察氯吡格雷治疗急性非ST段抬高心肌梗死(NSTEMI)的临床疗效及安全性。

 

myocardial 英 /,maɪəʊ'kɑːdɪəl/ 美 /,maɪə'kɑrdɪəl/ 

释    义   adj. 心肌的;n. 心肌衰弱

同根词   myocardium n. 心肌;心肌层

例    句   Stem cells transplantation bring new hope of treatment for myocardial infarction.

干细胞移植为心肌梗死的治疗带来了新的希望。

 

Infarction 英 /ɪn'fɑːkʃ(ə)n/   美 /ɪn'fɑrkʃən/

释    义   n. 梗塞;[病理] 梗塞形成,梗死形成

同根词   infarct n. 梗死;梗塞

例    句   Objective To evaluate the influence of amiodarone upon arrhythmia sudden death patients after myocardial infarction.

目的 评价胺碘酮对心肌梗塞后患者心律失常猝死的预防作用。

概述

定义 急性冠脉综合征(acute coronary syndrome, ACS)有3种类型:ST段抬高型心肌梗死(ST-segment elevation myocardial infarction, STEMI)、非ST段抬高型心肌梗死(non-ST elevation myocardial infarction, NSTEMI)和不稳定型心绞痛(unstable angina, UA)。其中,STEMI是指有持续胸部不适或提示缺血症状,持续超过20分钟,并且ECG至少两个相邻导联ST段抬高的

Acute Myocardial Infarction复制标题

急性心肌梗死

发表时间:2019-04-11

影响因子:79.3

作者: Jeffrey L. Anderson

期刊:N. Engl. J. Med

Acute myocardial infarction with or without ST-segment elevation (STEMI or non-STEMI) is a common cardiac emergency, with the potential for substantial morbidity and mortality. The management of acute myocardial infarction has improved dramatically over the past three decades and continues to evolve. Emergency reperfusion of ischemic myocardium that is in the process of becoming infarcted is the most important advance in the treatment of STEMI over the past three decades and is the primary therapeutic goal. Coronary reperfusion is accomplished by means of primary PCI (angioplasty and stenting) or intravenous fibrinolytic therapy. Prompt PCI (with a performance goal of ≤90 minutes from the first medical contact) is the preferred approach at PCI-capable hospitals for STEMI with onset of symptoms within the previous 12 hours (ACC–AHA class I recommendation, evidence level A) and for STEMI with cardiogenic shock, regardless of the timing (ACC–AHA class I recommendation, evidence level B). The advantages of primary PCI over fibrinolysis include lower rates of early death, reinfarction, and intracranial hemorrhage. However, when PCI is delayed by more than 120 minutes, fibrinolytic therapy should be given if it is not contraindicated (ACC–AHA class I recommendation, evidence level A), followed by routine consideration of transfer in the following 3 to 24 hours to a PCI-capable facility (ACC–AHA class IIa recommendation, evidence level B). With broad application of reperfusion therapy for STEMI, 30-day mortality rates have progressively declined from more than 20% to less than 5%.

译文

伴有或不伴有ST段抬高(STEMI或非STEMI)的急性心肌梗塞是常见的心脏急症,可能导致严重的发病率和死亡率。在过去三十年中,急性心肌梗塞的管理有了显着改善,并且还在不断发展。在过去三十年中,正在进行梗塞的缺血性心肌的紧急再灌注是STEMI治疗中最重要的进展,并且是主要的治疗目标。冠状动脉再灌注通过直接PCI(血管成形术和支架置入术)或静脉内纤维蛋白溶解疗法完成。即时PCI(性能目标是第一次医疗联系时间短于90分钟)是支持PCI的医院对STEMI的首选方法,在过去的12小时内出现症状(ACC-AHA I级推荐,证据级别A)和对于伴有心源性休克的STEMI,无论时间如何(ACC-AHA I级推荐,证据水平B)。直接PCI相对于纤维蛋白溶解的优点包括较低的早期死亡率,再梗塞率和颅内出血率。然而,当PCI延迟超过120分钟时,如果没有禁忌,应给予纤维蛋白溶解治疗(ACC-AHA I级推荐,证据级别A),然后在接下来的3到24小时内常规考虑转移至具有PCI功能的设施(ACC-AHA IIa类推荐,证据等级B)。随着STEMI再灌注治疗的广泛应用,30天死亡率从20%以上逐渐下降到不到5%。