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近10多年来的溶栓治疗使急性心肌梗死的治疗发生了质的变化。急性心肌梗死的处理重点已从过去的预防和治疗恶性心律失常转移到减少梗死范围和预防再梗死及心室重构方面,突出了心肌的挽救。引起急性心肌梗死(AMI)患者死亡的常见原因为:大面积梗死导致泵功能衰竭,出现致命的室性快速性心律失常或心脏停搏,心脏破裂,再梗死,梗死扩展和心室扩张。急性透壁性心肌梗死早期临床研究提示80%~90%的病人有冠脉血栓堵塞。AMI后如能及时溶解梗死相关冠脉内的血栓,则可降低死亡率,维持左室功能并改善预后。AMI的范围可通过溶解血栓,增加心肌血流,改善氧的供需而缩小。再梗死可
The treatment of acute myocardial infarction has undergone a qualitative change in thrombolytic therapy in the past 10 years. The focus of acute MI treatment has been to salvage myocardial salvage in the past from the prevention and treatment of malignant arrhythmias to the reduction of infarct size and prevention of reinfarction and ventricular remodeling. Common causes of death in patients with acute myocardial infarction (AMI) are: large infarcts leading to pump failure, fatal ventricular tachyarrhythmia or cardiac arrest, cardiac rupture, reinfarction, infarct expansion, and ventricular dilatation. Early clinical studies of acute transmural myocardial infarction suggest that 80% to 90% of patients have coronary artery thrombosis. AMI if timely dissolution of infarct-related coronary thrombosis, can reduce mortality, maintain left ventricular function and improve prognosis. The scope of AMI can be reduced by dissolving blood clots, increasing myocardial blood flow, and improving oxygen supply and demand. Then infarction can be