作者：丁绍祥

单位：

214000江苏省无锡市惠山区第二人民医院老年科

Units：

Geriatric Department, the Second People's Hospital of Huishan District, Wuxi 214000, China

关键词：

心肌梗死；ST段抬高型心肌梗死；再灌注治疗；经皮冠状动脉介入治疗

Keywords：

Myocardial infarction; ST segment elevation myocardial infarction; Reperfusion therapy; Percutaneous coronary intervention

CLC：

R 542.22

DOI：

10.12114/j.issn.1008-5971.2023.00.269

Funds：

江苏省老年健康科研面上项目（LKM2023033）；无 锡市科协重点申报课题（KX-21-C237）

摘要：

ST段抬高型心肌梗死（STEMI）是冠心病的严重类型，经皮冠状动脉介入治疗（PCI）是其最佳治疗 手段，可以恢复梗死区血液灌注，进而避免更多心肌坏死，但部分患者因各种原因而错过最佳治疗时机。因此，规 范STEMI患者超窗口期治疗策略对改善患者预后具有重要意义。近年来，针对有明确胸痛症状或血流动力学不稳定的 STEMI患者超窗口期行再灌注治疗无争议，但对血流动力学相对稳定的STEMI患者超窗口期行再灌注治疗存在较大争 议。本文主要综述了STEMI的病理特征及STEMI患者超窗口期再灌注治疗情况，以期为临床医生选择治疗方案提供一 定参考。

Abstract：

ST segment elevation myocardial infarction (STEMI) is a serious type of coronary heart disease, and percutaneous coronary intervention (PCI) is its best treatment method, which can restore blood perfusion in the infarcted area and avoid more myocardial necrosis. However, some patients miss the best treatment opportunity due to various reasons. Therefore, standardizing the treatment strategy for STEMI patients beyond the optimal time-window is of great significance in improving their prognosis. In recent years, there has been no controversy regarding reperfusion therapy for STEMI patients with clear chest pain symptoms or hemodynamic instability beyond the optimal time-window, but there is significant controversy regarding reperfusion therapy for STEMI patients with relatively stable hemodynamics beyond the optimal time-window. This article mainly reviews the pathological characteristics of STEMI and reperfusion therapy in STEMI patients beyond the optimal time-window, in order to provide some reference for clinical doctors to choose treatment plans.

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