【摘要】 急性心肌梗死(acute myocardial infarction,AMI)起病急、死亡率高,是心血管系统的主要急危重症之一。随着治疗方案的不断完善和优化,AMI患者的住院死亡率有所降低,但AMI后主要不良心血管事件的发病率仍然较高。因此,AMI治疗方案和救治策略的进一步优化仍是临床医生的迫切需求。本文就AMI后抗血小板聚集药物治疗时出血与缺血风险的权衡、梗死相关动脉开通时残留微循环障碍的考虑、非梗死相关血管处理合适时机的选择、其他二级预防治疗前的病情评估、器械治疗时患者远期受益的考量等几方面进行综述。更多还原

【Abstract】 Acute myocardial infarction( AMI) is one of the major critical diseases of the cardiovascular system with sudden onset and high mortality. Although the in-hospital mortality rate of AMI patients has been reduced due to the continuously improved and optimized therapeutic regimen,the incidence of major adverse cardiovascular events is still significantly high. Therefore,further optimizing the therapeutic regimen and treatment strategy for AMI is still urgently needed by clinicians. This paper reviews from the following aspects including the balance between the bleeding risk and ischemic risk in the use of antiplatelet aggregation drugs after AMI,the residual microcirculation disorder in the opening of infarct-related arteries,the timing of handling non-infarct related blood vessels,disease evaluation before other secondary preventive treatment,and the long-term benefits from mechanicallyassisted treatment.更多还原