第8版内科学课件急性ST段抬高型心肌梗死修改稿.ppt

* 中国的急性心梗流行现状也不容乐观，虽然从不同途径得到的发病率和死亡率不尽相同，但都提示有相当高的发病率和很高的死亡率，其中从复旦大学得到的一份流行病学资料显示，中国每年新发心肌梗死病例约70万例，而死亡病例则达到40万例。与前述美国的情况相比，发病率较低，而死亡率则高得多。提高我们患者心梗后的治疗水平和手段迫在眉睫。 在国内，心肌梗死每年新发病例70 万例，心肌梗死每年死亡病例40 万例。 【参考文献】 无（资料来源于复旦大学公共卫生学院资料，《健康报》 2002年7月24日。尚无权威官方数据。） 模板来自 / 模板来自于 * * Acute Coronary Syndrome is a term that refers to a group of clinical conditions that are defined by acute myocardial ischemia and associated with an increased risk of subsequent MI and cardiovascular death ACS includes the following conditions: Unstable Angina (UA) is defined as chest pain lasting greater than 20 minutes that is not relieved by rest. The pain generally appears unexpectedly and usually increases in frequency or intensity over time. Compared to stable angina, chest pain with unstable angina is usually more severe and prolonged. Patients with unstable angina have no evidence of cardiac tissue death Non-ST Segment Elevation Myocardial Infarction (NSTEMI) is defined as a myocardial infarction in which the patient’s electrocardiogram (ECG) reading shows no elevation of the ST segment. Patients will complain of chest pain and will have elevation of cardiac markers in their bloodstream. This elevation in cardiac markers, which reflects damage to the heart, differentiates an unstable angina patient from a patient with a NSTEMI. Although the arterial blockage may not be complete with a NSTEMI, it is sufficient to induce myocardial cell death. (NSTEMI is also sometimes referred to as non-Q wave MI) ST Segment Elevation Myocardial Infarction (STEMI) is defined as a myocardial infarction in which the patient’s ECG reading initially shows an elevation of the ST segment. Patients will experience severe chest pain in addition to having elevated sustained cardiac markers in their bloodstream. Patients with STEMI experience complete occlusion of an artery and more extensive cardiac tissue death. (STEMI is also sometimes referred to as Q-wave MI) * * * * * * * * * * * * * * Greatest empha