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\u5bf9NSTE-ACS\u60a3\u8005\u5e94\u5f53\u8fdb\u884c\u5371\u9669\u5206\u5c42\uff0c\u6839\u636e\u5371\u9669\u5206\u5c42\u51b3\u5b9a\u662f\u5426\u884c\u65e9\u671f\u8840\u8fd0\u91cd\u5efa\u6cbb\u7597\u3002\u63a8\u8350\u91c7\u7528\u5168\u7403\u6025\u6027\u51a0\u72b6\u52a8\u8109\u4e8b\u4ef6\u6ce8\u518c( GRACE)\u5371\u9669\u8bc4\u5206\u4f5c\u4e3a\u5371\u9669\u5206\u5c42\u7684\u9996\u9009\u8bc4\u5206\u65b9\u6cd5\u3002 <\/p>\n\n\n\n
\u51a0\u72b6\u52a8\u8109\u9020\u5f71\u82e5\u663e\u793a\u9002\u5408PCI\uff0c\u5e94\u6839\u636e\u51a0\u72b6\u52a8\u8109\u5f71\u50cf\u7279\u70b9\u548c\u5fc3\u7535\u56fe\u6765\u8bc6\u522b\u7f6a\u72af\u8840\u7ba1\u5e76\u5b9e\u65bd\u4ecb\u5165\u6cbb\u7597\uff1b\u82e5\u663e\u793a\u4e3a\u591a\u652f\u8840\u7ba1\u75c5\u53d8\u4e14\u96be\u4ee5\u5224\u65ad\u7f6a\u72af\u8840\u7ba1\uff0c\u6700\u597d\u884c\u8840\u6d41\u50a8\u5907\u5206\u6570\u68c0\u6d4b\u4ee5\u51b3\u5b9a\u6cbb\u7597\u7b56\u7565\u3002\u5efa\u8bae\u6839\u636eGRACE\u8bc4\u5206\u662f\u5426>140\u53ca\u9ad8\u5371\u56e0\u7d20\u7684\u591a\u5c11\uff0c\u4f5c\u4e3a\u9009\u62e9\u7d27\u6025(<2 h)\u3001\u65e9\u671f(<24 h)\u4ee5\u53ca\u5ef6\u8fdf\uff0872 h\u5185\uff09\u6709\u521b\u6cbb\u7597\u7b56\u7565\u7684\u4f9d\u636e\u3002<\/p>\n\n\n\n
\u9700\u8981\u884c\u7d27\u6025\u51a0\u72b6\u52a8\u8109\u9020\u5f71\u7684\u60c5\u51b5\uff1a(1)\u6301\u7eed\u6216\u53cd\u590d\u53d1\u4f5c\u7684\u7f3a\u8840\u75c7\u72b6\u3002(2)\u81ea\u53d1\u7684ST\u6bb5\u52a8\u6001\u6f14\u53d8\uff08\u538b\u4f4e>0.1 mV\u6216\u77ed\u6682\u62ac\u9ad8\uff09\u3002(3)\u524d\u58c1\u5bfc\u8054V2~V4\u6df1\u7684ST\u6bb5\u538b\u4f4e\uff0c\u63d0\u793a\u540e\u58c1\u900f\u58c1\u6027\u7f3a\u8840\u3002(4)\u8840\u6db2\u52a8\u529b\u5b66\u4e0d\u7a33\u5b9a\u3002(5)\u4e25\u91cd\u5ba4\u6027\u5fc3\u5f8b\u5931\u5e38\u3002<\/p>\n\n\n\n
\u6025\u6027ST\u6bb5\u62ac\u9ad8\u578b\u5fc3\u808c\u6897\u6b7b(STEMI)\u7684\u8840\u8fd0\u91cd\u5efa\u6cbb\u7597<\/p>\n\n\n\n
\u5bf9STEMI\u7684\u518d\u704c\u6ce8\u7b56\u7565\u4e3b\u8981\u5efa\u8bae\u5982\u4e0b\uff1a\u5efa\u7acb\u9662\u524d\u8bca\u65ad\u548c\u8f6c\u9001\u7f51\u7edc\uff0c\u5c06\u60a3\u8005\u5feb\u901f\u8f6c\u81f3\u53ef\u884c\u76f4\u63a5PCI\u7684\u4e2d\u5fc3(IA)\uff0c\u82e5\u60a3\u8005\u88ab\u9001\u5230\u6709\u6025\u8bcaPCI\u8bbe\u65bd\u4f46\u7f3a\u4e4f\u8db3\u591f\u6709\u8d44\u8d28\u533b\u751f\u7684\u533b\u7597\u673a\u6784\uff0c\u4e5f\u53ef\u8003\u8651\u4e0a\u7ea7\u533b\u9662\u7684\u533b\u751f\uff08\u4e8b\u5148\u5df2\u5efa\u7acb\u597d\u56fa\u5b9a\u8054\u7cfb\u8005\uff09\u8fc5\u901f\u5230\u8be5\u533b\u7597\u673a\u6784\u8fdb\u884c\u76f4\u63a5PCI(\u2161b C);\u6025\u8bcaPCI\u4e2d\u5fc3\u987b\u5efa\u7acb\u6bcf\u592924 h\u3001\u6bcf\u54687\u5929\u7684\u5e94\u6025\u7cfb\u7edf\uff0c\u5e76\u80fd\u5728\u63a5\u8bca90 min\u5185\u5f00\u59cb\u76f4\u63a5PCI(I B)\uff1b\u5982\u65e0\u76f4\u63a5PCI\u6761\u4ef6\uff0c\u60a3\u8005\u65e0\u6eb6\u6813\u7981\u5fcc\u8005\u5e94\u5c3d\u5feb\u6eb6\u6813\u6cbb\u7597\uff0c\u5e76\u8003\u8651\u7ed9\u4e88\u5168\u91cf\u6eb6\u6813\u5242\uff08\u2161a A\uff09\u9664\u5fc3\u539f\u6027\u4f11\u514b\u5916\uff0cPCI\uff08\u76f4\u63a5\u3001\u8865\u6551\u6216\u6eb6\u6813\u540e\uff09\u5e94\u4ec5\u9650\u4e8e\u5f00\u901a\u7f6a\u72af\u75c5\u53d8(\u2161a B)\uff1b\u5728\u53ef\u884c\u76f4\u63a5PCI\u7684\u4e2d\u5fc3\uff0c\u5e94\u907f\u514d\u5c06\u60a3\u8005\u5728\u6025\u8bca\u79d1\u6216\u76d1\u62a4\u75c5\u623f\u8fdb\u884c\u4e0d\u5fc5\u8981\u7684\u8f6c\u8fd0(\u2162A)\uff1b\u5bf9\u65e0\u8840\u6db2\u52a8\u529b\u5b66\u969c\u788d\u7684\u60a3\u8005\uff0c\u5e94\u907f\u514d\u5e38\u89c4\u5e94\u7528\u4e3b\u52a8\u8109\u7403\u56ca\u53cd\u640f(\u2162B)\u3002<\/p>\n\n\n\n
\u5fc3\u539f\u6027\u4f11\u514b\uff1a\u5bf9STEMI\u5408\u5e76\u5fc3\u539f\u6027\u4f11\u514b\u60a3\u8005\u4e0d\u8bba\u53d1\u75c5\u65f6\u95f4\u4e5f\u4e0d\u8bba\u662f\u5426\u66fe\u6eb6\u6813\u6cbb\u7597\uff0c\u5747\u5e94\u7d27\u6025\u51a0\u72b6\u52a8\u8109\u9020\u5f71\uff0c\u82e5\u75c5\u53d8\u9002\u5b9c\uff0c\u7acb\u5373\u76f4\u63a5PCI(I B)\uff0c\u5efa\u8bae\u5904\u7406\u6240\u6709\u4e3b\u8981\u8840\u7ba1\u7684\u4e25\u91cd\u75c5\u53d8\uff0c\u8fbe\u5230\u5b8c\u5168\u8840\u7ba1\u91cd\u5efa\uff1b\u836f\u7269\u6cbb\u7597\u540e\u8840\u6db2\u52a8\u529b\u5b66\u4e0d\u80fd\u8fc5\u901f\u7a33\u5b9a\u8005\u5e94\u7528\u4e3b\u52a8\u8109\u5185\u7403\u56ca\u53cd\u640f\u652f\u6301(IB)\u3002<\/p>\n\n\n\n
\u7279\u6b8a\u4eba\u7fa4\u8840\u8fd0\u91cd\u5efa\u6cbb\u7597<\/p>\n\n\n\n
1\uff0e\u7cd6\u5c3f\u75c5\uff1a\u51a0\u5fc3\u75c5\u5408\u5e76\u7cd6\u5c3f\u75c5\u60a3\u8005\u65e0\u8bba\u63a5\u53d7\u4f55\u79cd\u8840\u8fd0\u91cd\u5efa\u6cbb\u7597\uff0c\u9884\u540e\u90fd\u8f83\u975e\u7cd6\u5c3f\u75c5\u60a3\u8005\u5dee\uff0c\u518d\u72ed\u7a84\u7387\u4e5f\u9ad8\u3002\u5bf9\u4e8eSTEMI\u60a3\u8005\uff0c\u5728\u63a8\u8350\u65f6\u95f4\u671f\u9650\u5185PCI\u4f18\u4e8e\u6eb6\u6813(I A);\u5bf9\u4e8e\u7a33\u5b9a\u7684\u3001\u7f3a\u8840\u8303\u56f4\u5927\u7684\u51a0\u5fc3\u75c5\u60a3\u8005\uff0c\u5efa\u8bae\u884c\u8840\u8fd0\u91cd\u5efa\u4ee5\u589e\u52a0\u65e0\u4e3b\u8981\u4e0d\u826f\u5fc3\u8111\u8840\u7ba1\u4e8b\u4ef6\u751f\u5b58\u7387(IA)\uff1b\u4f7f\u7528\u836f\u7269\u6d17\u8131\u652f\u67b6( DES)\u4ee5\u51cf\u5c11\u518d\u72ed\u7a84\u53ca\u9776\u8840\u7ba1\u518d\u6b21\u8840\u8fd0\u91cd\u5efa(IA)\uff1b\u5bf9\u4e8e\u670d\u7528\u4e8c\u7532\u53cc\u80cd\u7684\u60a3\u8005\uff0c\u51a0\u72b6\u52a8\u8109\u9020\u5f71\/PCI\u672f\u540e\u5e94\u5bc6\u5207\u76d1\u6d4b\u80be\u529f\u80fd(IC)\uff1b\u7f3a\u8840\u8303\u56f4\u5927\u8005\u9002\u5408\u4e8e\u884cCABG\uff08\u7279\u522b\u662f\u591a\u652f\u75c5\u53d8\uff09\uff0c\u5982\u679c\u60a3\u8005\u624b\u672f\u98ce\u9669\u8bc4\u5206\u5728\u53ef\u63a5\u53d7\u7684\u8303\u56f4\u5185\uff0c\u63a8\u8350\u884cCA8G\u800c\u4e0d\u662fPCf(hra B)\uff1b\u5bf9\u5df2\u7fd8\u6709\u80be\u529f\u80fd\u635f\u5bb3\u7684\u60a3\u8005\u884cPCI\uff0c\u5e94\u5728\u672f\u524d\u505c\u7528\u4e8c\u7532\u53cc\u80cd(\u2161b C)\uff0c\u670d\u7528\u4e8c\u7532\u53cc\u80cd\u7684\u60a3\u8005\u51a0\u72b6\u52a8\u8109\u9020\u5f71\u6216PCI\u672f\u540e\u590d\u67e5\u53d1\u73b0\u80be\u529f\u80fd\u6709\u635f\u5bb3\u8005\uff0c\u4ea6\u5e94\u505c\u7528\u4e8c\u7532\u53cc\u80cd\uff1b\u4e0d\u5efa\u8bae\u5bf9\u8840\u8fd0\u91cd\u5efa\u7684\u7cd6\u5c3f\u75c5\u60a3\u8005\u9759\u8109\u5e94\u7528\u6781\u5316\u6db2(\u2162B)\u3002<\/p>\n\n\n\n
2\uff0e\u6162\u6027\u80be\u75c5\uff1a\u6162\u6027\u80be\u75c5\u60a3\u8005\u5fc3\u8840\u7ba1\u6b7b\u4ea1\u7387\u589e\u9ad8\uff0c\u7279\u522b\u662f\u5408\u5e76\u7cd6\u5c3f\u75c5\u8005\u3002\u82e5\u9002\u5e94\u8bc1\u9009\u62e9\u6b63\u786e\uff0c\u5fc3\u808c\u8840\u8fd0\u91cd\u5efa\u53ef\u4ee5\u6539\u5584\u8fd9\u7c7b\u60a3\u8005\u7684\u751f\u5b58\u7387\u3002\u5efa\u8bae\u672f\u524d\u5e94\u7528\u4f30\u7b97\u7684\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387(eGFR)\u8bc4\u4ef7\u60a3\u8005\u7684\u80be\u529f\u80fd\uff08\u8f7b\u5ea6\u80be\u529f\u80fd\u4e0d\u5168\uff1a60ml\uff0emin-1\uff0e1.73 m-2\u2264eGFR<90 ml\uff0emin_1.1.73m-2\uff1b\u4e2d\u5ea6\u80be\u529f\u80fd\u4e0d\u5168\uff1a30 ml\uff0emin-1\uff0e1.73 m-2\u2264eGFR<60 ml\uff0emin-1\uff0e1.73 m-2\uff1b\u91cd\u5ea6\u80be\u529f\u80fd\u4e0d\u5168\uff1aeGFR<30 ml\uff0emin-1\uff0e1.73 m-2\uff09\u3002\u5bf9\u4e8e\u8f7b\u3001\u4e2d\u5ea6\u6162\u6027\u80be\u75c5\uff0c\u51a0\u72b6\u52a8\u8109\u75c5\u53d8\u590d\u6742\u4e14\u53ef\u4ee5\u8010\u53d7CABG\u7684\u60a3\u8005\uff0c\u5efa\u8bae\u9996\u9009CABG(\u2161a B);\u82e5\u5b9e\u65bdPCI\u5e94\u8bc4\u4f30\u5bf9\u6bd4\u5242\u52a0\u91cd\u80be\u635f\u5bb3\u7684\u98ce\u9669\uff0c\u672f\u4e2d\u5c3d\u91cf\u4e25\u683c\u63a7\u5236\u5bf9\u6bd4\u5242\u7684\u7528\u91cf\uff0c\u4e14\u8003\u8651\u5e94\u7528DES\uff0c\u800c\u4e0d\u63a8\u8350\u7528\u88f8\u91d1\u5c5e\u652f\u67b6(BMS\uff0c\u2161b C)\u3002<\/p>\n\n\n\n
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3.\u5408\u5e76CHF\uff1a\u51a0\u5fc3\u75c5\u662fCHF\u7684\u4e3b\u8981\u539f\u56e0\u3002\u5408\u5e76CHF\u8005\u884c\u8840\u8fd0\u91cd\u5efa\u7684\u56f4\u672f\u671f\u6b7b\u4ea1\u98ce\u9669\u589e\u52a050%~30%\u3002\u5bf9\u4e8eCHF\u5408\u5e76\u5fc3\u7ede\u75db\u7684\u60a3\u8005\uff0c\u63a8\u8350CABG\u5e94\u7528\u4e8e\u660e\u663e\u7684\u5de6\u4e3b\u5e72\u72ed\u7a84\u3001\u5de6\u4e3b\u5e72\u7b49\u540c\u75c5\u53d8\uff08\u524d\u964d\u652f\u548c\u56de\u65cb\u652f\u7684\u8fd1\u6bb5\u72ed\u7a84\uff09\u4ee5\u53ca\u524d\u964d\u652f\u8fd1\u6bb5\u72ed\u7a84\u5408\u5e762\u62163\u652f\u8840\u7ba1\u75c5\u53d8\u60a3\u8005(I B)\u3002\u5de6\u5fc3\u5ba4\u6536\u7f29\u672b\u671f\u5bb9\u79ef\u6307\u6570>60 ml\/m2\u548c\u524d\u964d\u652f\u4f9b\u8840\u533a\u57df\u5b58\u5728\u75a4\u75d5\u7684\u60a3\u8005\u53ef\u8003\u8651\u884cCABG\uff0c\u5fc5\u8981\u65f6\u884c\u5de6\u5fc3\u5ba4\u91cd\u5efa\u672f(\u2161b B)\u3002\u5982\u51a0\u72b6\u52a8\u8109\u89e3\u5256\u9002\u5408\uff0c\u9884\u8ba1CABG\u56f4\u672f\u671f\u6b7b\u4ea1\u7387\u8f83\u9ad8\u6216\u4e0d\u80fd\u8010\u53d7\u5916\u79d1\u624b\u672f\u8005\uff0c\u53ef\u8003\u8651\u884cPCI(\u2161b C)\u3002<\/p>\n\n\n\n
4\uff0e\u518d\u6b21\u8840\u8fd0\u91cd\u5efa\uff1a\u5bf9\u4e8eCABG\u6216PCI\u672f\u540e\u51fa\u73b0\u6865\u8840\u7ba1\u5931\u8d25\u6216\u652f\u67b6\u5185\u518d\u72ed\u7a84\u3001\u652f\u67b6\u5185\u8840\u6813\u5f62\u6210\u7684\u60a3\u8005\uff0c\u53ef\u80fd\u9700\u8981\u518d\u6b21CABG\u6216PCI\u3002\u9009\u62e9\u518d\u6b21CABG\u6216PCI\u5e94\u7531\u5fc3\u810f\u56e2\u961f\u6216\u5fc3\u5185\u3001\u5916\u79d1\u533b\u751f\u4f1a\u8bca\u51b3\u5b9a\u3002<\/p>\n\n\n\n
\u7279\u6b8a\u75c5\u53d8\u7684PCI<\/p>\n\n\n\n
1\uff0e\u6162\u6027\u5b8c\u5168\u95ed\u585e\u75c5\u53d8(CTO)\u75c5\u53d8\u7684PCI:CTO\u5b9a\u4e49\u4e3a\u5927\u4e8e3\u4e2a\u6708\u7684\u8840\u7ba1\u95ed\u585e\u3002\u7591\u8bca\u51a0\u5fc3\u75c5\u7684\u60a3\u8005\u7ea61\/3\u9020\u5f71\u53ef\u89c1\u22651\u6761\u51a0\u72b6\u52a8\u8109CTO\u75c5\u53d8\u3002\u867d\u7136\u8fd9\u90e8\u5206\u60a3\u8005\u5927\u591a\u6570\uff08\u5373\u4f7f\u5b58\u5728\u4fa7\u652f\u5faa\u73af\uff09\u8d1f\u8377\u8bd5\u9a8c\u9633\u6027\uff0c\u4f46\u662f\u4ec5\u67098%~15%\u7684\u60a3\u8005\u63a5\u53d7PCI\u3002\u8fd9\u79cdCTO\u53d1\u75c5\u7387\u548c\u63a5\u53d7PCI\u7684\u6bd4\u4f8b\u5448\u660e\u663e\u53cd\u5dee\u7684\u539f\u56e0\uff0c\u4e00\u65b9\u9762\u662f\u5f00\u901aCTO\u75c5\u53d8\u6280\u672f\u8981\u6c42\u9ad8\u3001\u96be\u5ea6\u5927\uff0c\u53e6\u4e00\u65b9\u9762\u662f\u56e0\u4e3a\u5f00\u901aCTO\u540e\u60a3\u8005\u83b7\u76ca\u7a0b\u5ea6\u6709\u4e89\u8bae\u3002\u56e0\u6b64\u76ee\u524d\u8ba4\u4e3a\uff0c\u82e5\u60a3\u8005\u6709\u4e34\u5e8a\u7f3a\u8840\u75c7\u72b6\uff0c\u8840\u7ba1\u89e3\u5256\u6761\u4ef6\u5408\u9002\uff0c\u7531\u7ecf\u9a8c\u4e30\u5bcc\u7684\u672f\u8005\uff08\u6210\u529f\u7387> 80%\uff09\u5f00\u901aCTO\u662f\u5408\u7406\u7684(\u2161a B)\u3002CTO\u5f00\u901a\u540e\uff0c\u4e0e\u7f6e\u5165BMS\u6216\u7403\u56ca\u6269\u5f20\u5bf9\u6bd4\uff0c\u7f6e\u4ebaDES\u80fd\u663e\u8457\u964d\u4f4e\u9776\u8840\u7ba1\u91cd\u5efa\u7387(IB)\u3002<\/p>\n\n\n\n
2\uff0e\u5206\u53c9\u75c5\u53d8\u7684\u4ecb\u5165\u6cbb\u7597\uff1a\u5982\u8fb9\u652f\u8840\u7ba1\u4e0d\u5927\u4e14\u8fb9\u652f\u5f00\u53e3\u4ec5\u6709\u8f7b\u4e2d\u5ea6\u7684\u5c40\u9650\u6027\u75c5\u53d8\uff0c\u4e3b\u652f\u7f6e\u4eba\u652f\u67b6\u3001\u5fc5\u8981\u65f6\u8fb9\u652f\u7f6e\u5165\u652f\u67b6\u7684\u7b56\u7565\u5e94\u4f5c\u4e3a\u5206\u53c9\u75c5\u53d8\u6cbb\u7597\u7684\u9996\u9009\u7b56\u7565( IA)\u3002\u82e5\u8fb9\u652f\u8840\u7ba1\u7c97\u5927\u3001\u8fb9\u652f\u95ed\u585e\u98ce\u9669\u9ad8\u6216\u9884\u8ba1\u518d\u6b21\u9001\u4eba\u5bfc\u4e1d\u56f0\u96be\uff0c\u9009\u62e9\u53cc\u652f\u67b6\u7f6e\u5165\u7b56\u7565\u662f\u5408\u7406\u7684(\u2161a B)\u3002<\/p>\n\n\n\n
\u7279\u6b8a\u60c5\u51b5\u4e0bPCI\u624b\u672f\u76f8\u5173\u95ee\u9898<\/p>\n\n\n\n
\u5728\u67d0\u4e9b\u7279\u6b8a\u60c5\u51b5\u4e0b\uff0c\u9700\u8981\u5e94\u7528\u7279\u6b8a\u7684\u5668\u68b0\u548c\u836f\u7269\u534f\u52a9\u5b8c\u6210PCI\u3002<\/p>\n\n\n\n
\u5bf9\u4e8eDES\u7684\u5e94\u7528\uff0c\u5e94\u5f53\u5f3a\u8c03\u60a3\u8005\u80fd\u591f\u8010\u53d7\u5e76\u4f9d\u4ece\u81f3\u5c1112\u4e2a\u6708\u7684\u53cc\u8054\u6297\u8840\u5c0f\u677f\u836f\u7269\u3002DES\u5728\u4ee5\u4e0b\u60c5\u51b5\u4e0b\u4e0d\u5efa\u8bae\u5e94\u7528\uff1a(1)\u5728\u7d27\u6025\u60c5\u51b5\u4e0b\u4e0d\u80fd\u83b7\u5f97\u51c6\u786e\u4e34\u5e8a\u75c5\u53f2\u8005\u3002(2)\u5df2\u9884\u77e5\u670d\u7528\u53cc\u8054\u6297\u8840\u5c0f\u677f\u836f\u7269\u4f9d\u4ece\u6027\u5dee\uff0c\u5c24\u5176\u662f\u4f34\u6709\u591a\u79cd\u5168\u8eab\u75be\u75c5\u548c\u670d\u7528\u591a\u79cd\u836f\u7269\u7684\u60a3\u8005\u3002(3)\u77ed\u65f6\u95f4\u5185\u53ef\u80fd\u56e0\u9700\u8981\u63a5\u53d7\u5916\u79d1\u624b\u672f\u800c\u4e2d\u65ad\u53cc\u8054\u6297\u8840\u5c0f\u677f\u836f\u7269\u6cbb\u7597\u3002(4)\u6709\u9ad8\u51fa\u8840\u98ce\u9669\u3002(5)\u5bf9\u963f\u53f8\u5339\u6797\u3001\u6c2f\u5421\u683c\u96f7\u3001\u66ff\u683c\u745e\u6d1b\u3001\u666e\u62c9\u683c\u96f7\u7b49\u6297\u8840\u5c0f\u677f\u836f\u7269\u8fc7\u654f\u3002(6)\u60a3\u8005\u6709\u9700\u8981\u957f\u671f\u6297\u51dd\u7684\u5f3a\u70c8\u6307\u5f81\u3002<\/p>\n\n\n\n
\u6297\u6813\u836f\u7269<\/p>\n\n\n\n
\u4e00\u3001\u62e9\u671fPCI<\/p>\n\n\n\n
1\uff0e\u963f\u53f8\u5339\u6797\uff1a\u672f\u524d\u5df2\u63a5\u53d7\u957f\u671f\u963f\u53f8\u5339\u6797\u6cbb\u7597\u7684\u60a3\u8005\u5e94\u5728PCI\u524d\u670d\u7528\u963f\u53f8\u5339\u6797100~300 mg\u3002\u4ee5\u5f80\u672a\u670d\u7528\u963f\u53f8\u5339\u6797\u7684\u60a3\u8005\u5e94\u5728PCI\u672f\u524d\u81f3\u5c112h\uff0c\u6700\u597d24 h\u524d\u7ed9\u4e88\u963f\u53f8\u5339\u6797300 mg\u53e3\u670d\u3002<\/p>\n\n\n\n
2\uff0e\u6c2f\u5421\u683c\u96f7\uff1aPCI\u672f\u524d\u5e94\u7ed9\u4e88\u8d1f\u8377\u5242\u91cf\u6c2f\u5421\u683c\u96f7\uff0c\u672f\u524d6h\u6216\u66f4\u65e9\u670d\u7528\u8005\uff0c\u901a\u5e38\u7ed9\u4e88\u6c2f\u5421\u683c\u96f7300 mg\u8d1f\u8377\u5242\u91cf\u3002\u5982\u679c\u672f\u524d6h\u672a\u670d\u7528\u6c2f\u5421\u683c\u96f7\uff0c\u53ef\u7ed9\u4e88\u6c2f\u5421\u683c\u96f7600 mg\u8d1f\u8377\u5242\u91cf\uff0c\u6b64\u540e\u7ed9\u4e8875 mg\/d\u7ef4\u6301\u3002\u51a0\u72b6\u52a8\u8109\u9020\u5f71\u9634\u6027\u6216\u75c5\u53d8\u4e0d\u9700\u8981\u8fdb\u884c\u4ecb\u5165\u6cbb\u7597\u53ef\u505c\u7528\u6c2f\u5421\u683c\u96f7\u3002<\/p>\n\n\n\n
3\uff0e\u809d\u7d20\uff1a\u809d\u7d20\u662f\u76ee\u524d\u6807\u51c6\u7684\u672f\u4e2d\u6297\u51dd\u836f\u7269\u3002\u4e0e\u8840\u5c0f\u677f\u7cd6\u86cb\u767d( GP)\u2161b\uff0f\u2162a\u53d7\u4f53\u62ee\u6297\u5242\u5408\u7528\u8005\uff0c\u56f4\u672f\u671f\u666e\u901a\u809d\u7d20\u5242\u91cf\u5e94\u4e3a50~70 U\/kg;\u5982\u672a\u4e0eGP\u2161b\/\u2162a\u53d7\u4f53\u62ee\u6297\u5242\u5408\u7528\uff0c\u56f4\u672f\u671f\u666e\u901a\u809d\u7d20\u5242\u91cf\u5e94\u4e3a70\uff5e100 U\/kg\u3002<\/p>\n\n\n\n
\u4e8c\u3001NSTE-ACS\u7684PCI<\/p>\n\n\n\n
1\uff0e\u963f\u53f8\u5339\u6797\uff1a\u4ee5\u5f80\u672a\u670d\u7528\u963f\u53f8\u5339\u6797\u7684\u60a3\u8005\u5e94\u5728PCI\u672f\u524d\u7ed9\u4e88\u963f\u53f8\u5339\u6797\u8d1f\u8377\u91cf300 mg\u53e3\u670d\uff0c\u5df2\u670d\u7528\u963f\u53f8\u5339\u6797\u7684\u60a3\u8005\u672f\u524d\u7ed9\u4e88\u963f\u53f8\u5339\u6797100~300 mg\u53e3\u670d\u3002<\/p>\n\n\n\n
2\uff0e\u6c2f\u5421\u683c\u96f7\u3001\u66ff\u683c\u745e\u6d1b\u6216\u666e\u62c9\u683c\u96f7\uff1a\u672a\u670d\u7528\u8fc7\u6c2f\u5421\u683c\u96f7\u8005\u672f\u524d\u53ef\u7ed9\u4e88600 mg\u8d1f\u8377\u5242\u91cf\uff0c\u5176\u540e75 mg\/d\u7ee7\u7eed\u7ef4\u6301\u3002\u6709\u7814\u7a76\u8868\u660e\uff0c\u672f\u540e\u6c2f\u5421\u683c\u96f7150 mg\/d\uff0c\u7ef4\u63017d\uff0c\u4ee5\u540e\u6539\u4e3a75mg\/d\u7ef4\u6301\uff0c\u53ef\u51cf\u5c11\u5fc3\u8840\u7ba1\u4e0d\u826f\u4e8b\u4ef6\u800c\u4e0d\u660e\u663e\u589e\u52a0\u51fa\u8840[1\uff0c8]\u3002<\/p>\n\n\n\n
\u5df2\u670d\u7528\u8fc7\u6c2f\u5421\u683c\u96f7\u7684NSTE-ACS\u60a3\u8005\uff0c\u53ef\u8003\u8651\u672f\u524d\u518d\u7ed9\u4e88\u6c2f\u5421\u683c\u96f7300~600 mg\u8d1f\u8377\u5242\u91cf\u3002\u6216\u53e3\u670d\u66ff\u683c\u745e\u6d1b\u8d1f\u8377\u5242\u91cf180 mg\uff0c\u7ef4\u6301\u5242\u91cf90 mg\u30012\u6b21\/d\uff1b\u6216\u53e3\u670d\u666e\u62c9\u683c\u96f7\u8d1f\u8377\u91cf60 mg\uff0c\u7ef4\u6301\u5242\u91cf10 mg\/d\u3002<\/p>\n\n\n\n
3\uff0eGP\u2161b\uff0f\u2162a\u53d7\u4f53\u62ee\u6297\u5242\uff1a\u5efa\u8bae\u9ad8\u5371\u7f3a\u8840\u98ce\u9669\u7684\u60a3\u8005\u5b9e\u65bdPCI\u65f6\u4f7f\u7528\u66ff\u7f57\u975e\u73ed\u3002<\/p>\n\n\n\n
4\uff0e\u672f\u524d\u53ca\u672f\u540e\u6297\u51dd\u836f\u7269\u7684\u4f7f\u7528\uff1a\u809d\u7d20\u548c\u4f4e\u5206\u5b50\u809d\u7d20\u5e94\u907f\u514d\u4ea4\u53c9\u4f7f\u7528\u3002\u78fa\u8fbe\u809d\u7678\u94a0\u4e0d\u5efa\u8bae\u5e94\u7528\u4e8eeGFR<20 ml\uff0emin -1.1.73m-2\u7684\u60a3\u8005\uff1b\u5bf9eGFR\u226520 ml\uff0emin -1.1.73m-2\u7684\u80be\u529f\u80fd\u4e0d\u5168\u60a3\u8005\u4e0d\u9700\u8981\u51cf\u5c11\u5242\u91cf\u3002\u5bf9eGFR<30 ml\uff0emin -1.1.73m-2\u7684\u60a3\u8005\u4e0d\u5efa\u8bae\u7528\u4f9d\u8bfa\u809d\u7d20\uff1b\u5bf9eGFR 30~60 ml\uff0emin -1.1.73m-2\u7684\u80be\u529f\u80fd\u4e0d\u5168\u60a3\u8005\u5efa\u8bae\u51cf\u534a\u91cf\u3002\u9664\u975e\u5b58\u5728\u53d1\u751f\u8840\u6813\u9ad8\u5371\u9669\u56e0\u7d20\u7b49\u7279\u6b8a\u60c5\u51b5\uff0cPCI\u672f\u540e\u4e00\u822c\u53ef\u505c\u7528\u6297\u51dd\u836f\u7269\u3002<\/p>\n\n\n\n
\u5bf9\u9ad8\u5371\u7f3a\u8840\u98ce\u9669\u4eba\u7fa4\uff08\u6301\u7eed\u6027\u5fc3\u7ede\u75db\u3001\u8840\u6db2\u52a8\u529b\u5b66\u4e0d\u7a33\u5b9a\u3001\u96be\u6cbb\u6027\u5fc3\u5f8b\u5931\u5e38\uff09\uff0c\u5e94\u7acb\u5373\u9001\u4eba\u5bfc\u7ba1\u5ba4\uff0c\u5728\u8054\u5408\u5e94\u7528\u53cc\u8054\u6297\u8840\u5c0f\u677f\u836f\u7269\u7684\u540c\u65f6\uff0c\u4e00\u6b21\u6027\u9759\u8109\u6ce8\u5c04\u666e\u901a\u809d\u7d20\uff0c\u5176\u540e\u5b9e\u65bdPCI\uff0c\u672f\u4e2d\u5fc5\u8981\u65f6\u8ffd\u52a0\u809d\u7d20\u3002<\/p>\n\n\n\n
\u5bf9\u6709\u9ad8\u5371\u51fa\u8840\u98ce\u9669\u7684\u60a3\u8005\uff0c\u53ef\u4ee5\u8003\u8651\u7528\u6bd4\u4f10\u5362\u5b9a\u66ff\u4ee3\u809d\u7d20\u3002<\/p>\n\n\n\n
\u5bf9\u4e2d\u9ad8\u5ea6\u7f3a\u8840\u98ce\u9669\uff08\u808c\u9499\u86cb\u767d\u9633\u6027\u3001\u518d\u53d1\u5fc3\u7ede\u75db\u3001ST\u6bb5\u52a8\u6001\u53d8\u5316\uff09\uff0c\u5e76\u8ba1\u5212\u572824~48 h\u5185\u5b9e\u65bdPCI\u7684\u60a3\u8005\uff0c\u53ef\u4e8e\u672f\u524d\u5f00\u59cb\u4f7f\u7528\u809d\u7d2060 U\/kg\uff0c\u6216\u4f9d\u8bfa\u809d\u7d201 mg\uff0ekg-l. 12 h-l\uff0875\u5c81\u4ee5\u4e0a\u80050.75 mg\uff0ekg-l. 12 h-l\uff09\uff0c\u6216\u78fa\u8fbe\u809d\u7678\u94a02.5mg\/d\u76ae\u4e0b\u6ce8\u5c04\uff0c\u6216\u6bd4\u4f10\u5362\u5b9a0.1 mg\/kg\u9759\u8109\u6ce8\u5c04\uff08\u5176\u540e0.25 mg\uff0ekg-l. h-l\u7ef4\u6301\uff09\u3002<\/p>\n\n\n\n
\u5bf9\u4f4e\u7f3a\u8840\u98ce\u9669\uff08\u808c\u9499\u86cb\u767d\u9634\u6027\uff0c\u65e0ST\u6bb5\u6539\u53d8\uff09\u7684\u60a3\u8005\uff0c\u63a8\u8350\u4f7f\u7528\u4fdd\u5b88\u6cbb\u7597\u7b56\u7565\u3002\u5efa\u8bae\u78fa\u8fbe\u809d\u7678\u94a02.5 mg\/d\u76ae\u4e0b\u6ce8\u5c04\uff0c\u6216\u4f9d\u8bfa\u809d\u7d201 mg\uff0ekg-l. 12 h-l (75\u5c81\u4ee5\u4e0a\u80050.75 mg\uff0ekg-l. 12 h-l)\u76ae\u4e0b\u6ce8\u5c04\u3002<\/p>\n\n\n\n
5\uff0e\u672f\u4e2d\u6297\u51dd\u836f\u7269\u7684\u4f7f\u7528\uff1aPCI\u672f\u4e2d\u666e\u901a\u809d\u7d20\u4e0eGP\u2161b\uff0f\u2162a\u53d7\u4f53\u62ee\u6297\u5242\u5408\u7528\u8005\uff0c\u6d3b\u5316\u51dd\u8840\u65f6\u95f4( ACT)\u5e94\u7ef4\u6301\u5728200~250 s\uff1b\u5982\u672a\u5408\u7528GP\u2161b\uff0f\u2162a\u53d7\u4f53\u62ee\u6297\u5242\uff0cACT\u5e94\u7ef4\u6301\u4e8e250~350 s\u3002ACT\u964d\u81f3150~180 s\u4ee5\u4e0b\u65f6\u53ef\u62d4\u9664\u80a1\u52a8\u8109\u9798\u7ba1\u3002<\/p>\n\n\n\n
\u5982\u679c\u56f4\u672f\u671f\u4f7f\u7528\u4e86\u8db3\u91cf\u4f9d\u8bfa\u809d\u7d20(1 mg\/kg)\u76ae\u4e0b\u6ce8\u5c04\u81f3\u5c112\u6b21\uff0c\u8ddd\u79bb\u4f9d\u8bfa\u809d\u7d20\u6700\u540e\u4e00\u6b21\u4f7f\u7528\u65f6\u95f4<8 h\uff0c\u5728PCI\u672f\u4e2d\u4e0d\u9700\u8981\u8ffd\u52a0\u4f9d\u8bfa\u809d\u7d20\uff1b\u5982\u672f\u524d\u4f9d\u8bfa\u809d\u7d20\u76ae\u4e0b\u6ce8\u5c04\u5c11\u4e8e2\u6b21\uff0c\u6216\u8ddd\u79bb\u4f9d\u8bfa\u809d\u7d20\u6700\u540e\u4e00\u6b21\u4f7f\u7528\u65f6\u95f48-12 h\uff0c\u5219\u8ffd\u52a0\u4f9d\u8bfa\u809d\u7d20\uff0c\u5242\u91cf0. 30 mg\/kg\uff1b\u5982\u8ddd\u79bb\u4f9d\u8bfa\u809d\u7d20\u6700\u540e\u4e00\u6b21\u4f7f\u7528\u65f6\u95f4\u8d85\u8fc712 h\uff0c\u5219\u6309\u71670.75 mg\/kg\u5242\u91cf\u8ffd\u52a0\u4f9d\u8bfa\u809d\u7d20\u3002\u5982\u672f\u524d\u4f7f\u7528\u4e86\u6bd4\u4f10\u5362\u5b9a\uff0c\u5219\u5728PCI\u5f00\u59cb\u524d\u8ffd\u52a00.5 mg\/kg\uff0c\u5176\u540e\u63091.75 mg\uff0ekg-1\uff0eh-l\u7684\u5242\u91cf\u6301\u7eed\u9759\u8109\u6ef4\u6ce8\u3002\u5982\u672f\u524d\u4f7f\u7528\u4e86\u78fa\u8fbe\u809d\u7678\u94a0\uff0c\u5219\u5fc5\u987b\u5728PCI\u5b9e\u65bd\u65f6\u8ffd\u52a0\u809d\u7d2050~100 U\/kg\u3002\u5efa\u8bae\u5bf9\u9ad8\u5371\u91cd\u75c7\u60a3\u8005\u4ecd\u4ee5\u4f7f\u7528\u666e\u901a\u809d\u7d20\u4e3a\u5b9c\uff0c\u5e76\u5728ACT\u6c34\u5e73\u76d1\u6d4b\u4e0b\u5b9e\u65bdPCI\u3002<\/p>\n\n\n\n
\u4e09\u3001STEMI\u7684\u76f4\u63a5PCI<\/p>\n\n\n\n
1\uff0e\u963f\u53f8\u5339\u6797\uff1a\u672a\u670d\u7528\u8fc7\u963f\u53f8\u5339\u6797\u7684\u60a3\u8005\u672f\u524d\u7ed9\u4e88\u963f\u53f8\u5339\u6797\u8d1f\u8377\u91cf300 mg\uff0c\u5df2\u670d\u7528\u963f\u53f8\u5339\u6797\u7684\u60a3\u8005\u7ed9\u4e88100 N300 mg\u53e3\u670d\u3002<\/p>\n\n\n\n
2\uff0e\u6c2f\u5421\u683c\u96f7\u3001\u66ff\u683c\u745e\u6d1b\u6216\u666e\u62c9\u683c\u96f7\uff1a\u672a\u670d\u7528\u8fc7\u6c2f\u5421\u683c\u96f7\u8005\u53ef\u7ed9\u4e88600 mg\u8d1f\u8377\u5242\u91cf\uff0c\u5176\u540e75 mg\/d\u7ee7\u7eed\u7ef4\u6301\uff0c\u6216\u66ff\u683c\u745e\u6d1b\u53e3\u670d\u8d1f\u8377\u5242\u91cf180 mg\uff0c\u7ef4\u6301\u5242\u91cf90 mg\u30012\u6b21\/d\uff1b\u6216\u666e\u62c9\u683c\u96f7\u53e3\u670d\u8d1f\u8377\u5242\u91cf60 mg\uff0c\u7ef4\u6301\u5242\u91cf10 mg\/d\u3002<\/p>\n\n\n\n
3\uff0eGP\u2161b\/\u2162a\u53d7\u4f53\u62ee\u6297\u5242\uff1aPCI\u672f\u524d\u4f7f\u7528GP\u2161b\/\u2162a\u53d7\u4f53\u62ee\u6297\u5242\u9884\u6cbb\u7597\u662f\u5426\u6709\u5229\u76ee\u524d\u4ecd\u6709\u4e89\u8bae\u3002\u5173\u4e8eGP\u2161b\/\u2162a\u53d7\u4f53\u62ee\u6297\u5242\u5728PCI\u672f\u4e2d\u7684\u5e94\u7528\uff0c\u65e0\u8bba\u60a3\u8005\u672f\u524d\u662f\u5426\u5e94\u7528\u8fc7\u6c2f\u5421\u683c\u96f7\uff0c\u672f\u4e2d\u5747\u53ef\u5e94\u7528GP\u2161b\/\u2162a\u53d7\u4f53\u62ee\u6297\u5242\uff0c\u8bc1\u636e\u7b49\u7ea7\u5206\u522b\u4e3a\u2161aC\u548c\u2161aA\u3002\u6839\u636e\u4e2d\u56fd\u5fc3\u8840\u7ba1\u533b\u751f\u4e34\u5e8a\u5e94\u7528\u7684\u7ecf\u9a8c\uff0c\u5bf9\u4e8e\u5bcc\u542b\u8840\u6813\u75c5\u53d8\u7684\u60a3\u8005\u884cPCI\u65f6\uff0c\u53ef\u4ee5\u8003\u8651\u51a0\u72b6\u52a8\u8109\u5185\u63a8\u6ce8\u66ff\u7f57\u975e\u73ed\uff0c\u63a8\u8350\u5242\u91cf500~750 pug\/\u6b21\uff0c\u6bcf\u6b21\u95f4\u96943\uff5e5 min\uff0c\u603b\u91cf1500~2250 pdg\u3002<\/p>\n\n\n\n
4\uff0e\u672f\u4e2d\u6297\u51dd\u836f\u7269\uff1aPCI\u672f\u524d\u7528\u8fc7\u666e\u901a\u809d\u7d20\u8005\uff0cPCI\u672f\u4e2d\u6839\u636eACT\u6d4b\u5b9a\u503c\u5fc5\u8981\u65f6\u8ffd\u52a0\u666e\u901a\u809d\u7d20\uff0c\u5e76\u53ef\u8003\u8651\u5e94\u7528GP\u2161b\/\u2162a\u53d7\u4f53\u62ee\u6297\u5242\u3002\u4e0eGP\u2161b\/\u2162a\u53d7\u4f53\u62ee\u6297\u5242\u5408\u7528\u8005\uff0c\u672f\u4e2d\u666e\u901a\u809d\u7d20\u5242\u91cf\u5e94\u4e3a60 U\/kg\uff1b\u672a\u4e0eGP\u2161b\/\u2162a\u53d7\u4f53\u62ee\u6297\u5242\u5408\u7528\u8005\uff0c\u672f\u4e2d\u666e\u901a\u809d\u7d20\u5242\u91cf\u5e94\u4e3a100 U\/kg\u3002\u4e5f\u53ef\u4f7f\u7528\u6bd4\u4f10\u5362\u5b9a0.75 mg\/kg\uff0c\u5176\u540e1.75 mg\uff0ekg-l h-l\u7ef4\u6301\u3002<\/p>\n\n\n\n
\u56db\u3001\u53cc\u8054\u6297\u8840\u5c0f\u677f\u836f\u7269\u5e94\u7528\u6301\u7eed\u65f6\u95f4<\/p>\n\n\n\n
\u672f\u540e\u963f\u53f8\u5339\u6797100 mg\/d\u957f\u671f\u7ef4\u6301\u3002\u63a5\u53d7BMS\u7684\u60a3\u8005\u672f\u540e\u5408\u7528\u6c2f\u5421\u683c\u96f7\u7684\u53cc\u8054\u6297\u8840\u5c0f\u677f\u836f\u7269\u6cbb\u7597\u81f3\u5c111\u4e2a\u6708\uff0c\u6700\u597d\u6301\u7eed\u5e94\u752812\u4e2a\u6708( IB)\u3002\u7f6e\u4ebaDES\u7684\u60a3\u8005\u53cc\u8054\u6297\u8840\u5c0f\u677f\u6cbb\u7597\u81f3\u5c1112\u4e2a\u6708(IB)\u3002\u4f46\u5bf9ACS\u60a3\u8005\uff0c\u65e0\u8bba\u7f6e\u4ebaBMS\u6216DES\uff0c\u53cc\u8054\u6297\u8840\u5c0f\u677f\u836f\u7269\u6cbb\u7597\u81f3\u5c11\u6301\u7eed\u5e94\u752812\u4e2a\u6708(IB)\u3002 <\/p>\n\n\n\n
\u53cc\u8054\u6297\u8840\u5c0f\u677f\u836f\u7269\u5e94\u7528\u8fc7\u7a0b\u4e2d\u5e94\u76d1\u6d4b\u5e76\u9884\u9632\u51fa\u8840\u3002<\/p>\n\n\n\n
\u51fa\u8840\u7684\u5b9a\u4e49\u53ca\u5206\u578b\u5efa\u8bae\u91c7\u7528\u201c\u5b66\u672f\u7814\u7a76\u8054\u76df\u201d(ARC)\u65b0\u8fd1\u53d1\u8868\u7684\u5fc3\u8840\u7ba1\u7814\u7a76\u4e2d\u6807\u51c6\u5316\u7684\u51fa\u8840\u5b9a\u4e49[10]\u3002<\/p>\n\n\n\n
\u8840\u8fd0\u91cd\u5efa\u540e\u957f\u671f\u751f\u6d3b\u65b9\u5f0f\u548c\u5371\u9669\u56e0\u7d20\u7684\u63a7\u5236<\/p>\n\n\n\n
\u8840\u8fd0\u91cd\u5efa\u672f\u540e\u5e94\u5f53\u5b9a\u671f\u8fdb\u884c\u5168\u9762\u7684\u4e34\u5e8a\u548c\u9884\u540e\u8bc4\u4f30\uff0c\u5305\u62ec\u5b9a\u671f\u8fdb\u884c\u5fc3\u7535\u56fe\u3001\u5b9e\u9a8c\u5ba4\u68c0\u67e5\u3001\u8fd0\u52a8\u8bd5\u9a8c\u53ca\u8d85\u58f0\u5fc3\u52a8\u56fe\u68c0\u6d4b\u3002<\/p>\n\n\n\n
\u5bf9\u9ad8\u5371\u60a3\u8005\uff08\u5982\u8fd1\u671f\u8840\u8fd0\u91cd\u5efa\uff0cCHF\u7b49\uff09\u5236\u5b9a\u533b\u5b66\u76d1\u7763\u8ba1\u5212\u3002 \u5e94\u5f53\u5bf9\u60a3\u8005\u8fdb\u884c\u5065\u5eb7\u6559\u80b2\uff0c\u5631\u5176\u575a\u6301\u6bcf\u54685\u6b21\uff0c\u81f3\u5c11\u6bcf\u59291\u6b2130~60 min\u9002\u5f53\u5f3a\u5ea6\u7684\u6709\u6c27\u8fd0\u52a8\u3002<\/p>\n\n\n\n
\u996e\u98df\u548c\u4f53\u91cd\u7684\u63a7\u5236\u6807\u51c6\uff1a\u9f13\u52b1\u63a7\u5236\u4f53\u8d28\u91cf(\u4f53\u8d28\u6307\u6570<24 kg\/m2)\uff0c\u7537\u6027\u8170\u56f4<90 cm\uff0c\u5973\u6027\u8170\u56f4<80 cm\u3002\u5efa\u8bae\u6bcf\u6b21\u5065\u5eb7\u68c0\u67e5\u90fd\u8981\u8bc4\u4f30\u4f53\u8d28\u6307\u6570\u548c\uff08\u6216\uff09\u8170\u56f4\u3002\u5e94\u5c06\u964d\u4f4e\u57fa\u7ebf\u4f53\u91cd\u6807\u51c6\u768410%\u4f5c\u4e3a\u51cf\u80a5\u6cbb\u7597\u7684\u521d\u59cb\u76ee\u6807\u3002<\/p>\n\n\n\n
\u63a8\u8350\u9009\u62e9\u5065\u5eb7\u98df\u54c1\uff0c\u6539\u53d8\u751f\u6d3b\u65b9\u5f0f\u3001\u996e\u98df\u7597\u6cd5\u53ca\u836f\u7269\u6cbb\u7597\u3002\u5c06LDL-C\u63a7\u5236\u4e8e<2.6 mmol\/L(100 mg\/dl)\u3002\u5728\u6781\u9ad8\u5371\u4eba\u7fa4\u4e2d\uff0c\u63a7\u5236LDL-C <2.0 mmol\/L(80 mg\/dl)\u3002\u63a8\u8350\u66f4\u591a\u6444\u4eba\u5bcc\u542b\u4e0d\u9971\u548c\u8102\u80aa\u9178\u7684\u98df\u7269\u5982\u542b\u6709Omega-3\u8102\u80aa\u9178\u7684\u9c7c\u7c7b\u7b49\u3002\u901a\u8fc7\u836f\u7269\u6cbb\u7597\u548c\u751f\u6d3b\u65b9\u5f0f\u7684\u6539\u53d8\u4f7f\u8840\u538b\u63a7\u5236< 130\/80 mm Hg(l mm Hg =0.133 kPa)\u3002<\/p>\n\n\n\n
\u65e0\u8bba\u5176\u8840\u8102\u6c34\u5e73\u5982\u4f55\uff0c\u9664\u975e\u5b58\u5728\u7981\u5fcc\u8bc1\uff0c\u6240\u6709\u60a3\u8005\u5747\u5e94\u4f7f\u7528\u4ed6\u6c40\u7c7b\u836f\u7269\u3002\u03b2\u53d7\u4f53\u963b\u6ede\u5242\u548cACEI\u5e94\u4f5c\u4e3a\u4e00\u7ebf\u7528\u836f\u3002<\/p>\n\n\n\n
\u63a8\u8350\u5728\u6bcf\u6b21\u968f\u8bbf\u65f6\u5411\u60a3\u8005\u5f3a\u8c03\u6212\u70df\u548c\u63a7\u5236\u5438\u4e8c\u624b\u70df\u7684\u91cd\u8981\u6027\u3002<\/p>\n\n\n\n
\u5bf9\u7cd6\u5c3f\u75c5\u60a3\u8005\u8981\u7740\u91cd\u5f3a\u8c03\uff1a\u901a\u8fc7\u6539\u53d8\u751f\u6d3b\u65b9\u5f0f\u548c\u575a\u6301\u836f\u7269\u6cbb\u7597\u8fbe\u5230HbAlc<6.5%~7.0%\u7684\u6807\u51c6\u3002\u4e25\u683c\u63a7\u5236\u5176\u4ed6\u5371\u9669\u56e0\u7d20\u3002\u7531\u4e13\u4e1a\u7684\u5185\u79d1\u533b\u751f\u6307\u5bfc\u7cd6\u5c3f\u75c5\u6cbb\u7597\u3002\uff08\u6267\u7b14\uff1a\u97e9\u96c5\u73b2\uff09 <\/p>\n\n\n\n
\u5ba1\u6838\u4e13\u5bb6\uff1a <\/p>\n\n\n\n
\u80e1\u5927\u4e00 \u9ad8\u6da6\u9716 \u97e9\u96c5\u73b2 \u6768\u8dc3\u8fdb\u5085\u5411\u534e \u970d \u52c7 <\/p>\n\n\n\n
\u4e13\u5bb6\u7ec4\u6210\u5458\uff08\u6309\u59d3\u6c0f\u62fc\u97f3\u6392\u5e8f\uff09\uff1a <\/p>\n\n\n\n
\u9648 \u65b9 \u9648\u7eaa\u6797 \u9648\u7eaa\u8a00 \u9648\u541b\u67f1 \u9648\u826f\u9f99 \u9648\u7ecd\u826f \u9648\u97f5\u5cb1 \u7a0b\u6653\u66d9 \u675c\u5fd7\u6c11 \u65b9\u552f\u4e00 <\/p>\n\n\n\n
\u5085\u5411\u534e \u5085\u56fd\u80dc \u9ad8 \u709c \u9ad8\u4f20\u7389 \u9ad8\u6da6\u9716 \u845b\u5747\u6ce2 \u683c\u6851\u7f57\u5e03 \u5149\u96ea\u5cf0 \u90ed\u6587\u6021 <\/p>\n\n\n\n
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[1] Task Force on Myocardial Revascularization of the EuropeanSociety of Cardiology ( ESC) and the European Association forCardio-Thoracic Surgery ( EACTS), European Association forPercutaneous Cardiovascular Interventions ( EAPCI) , Wijns W, et al. Guidelines on myocardial revascularization. Eur Heart J,2010 ,31:2501-2555. <\/p>\n\n\n\n
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[3] Hillis LD, Smith PK, Anderson JL, et al. 2011 ACCF\/AHA guideline for coronary artery bypass graft surgery. A report of the American College of Cardiology Foundation\/American Heart Association task force on practice guidelines. developed in collaboration with the American Association for Thoracic Surgery, Society of Cardiovascular Anesthesiologists, and Society of Thoracic Surgeons. J Am Coll Cardiol, 2011,58:e123-210. <\/p>\n\n\n\n
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[5] Serruys PW, Morice MC, Kappetein AP, et al. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med,2009,360:961- 972. <\/p>\n\n\n\n
[6] Peterson ED, Dai D, DeLong ER,et al. Contemporary mortality risk prediction for percutaneous coronary intervention: results from 588,398 procedures in the National <\/p>\n","protected":false},"excerpt":{"rendered":"
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