07 stemi treatment in areas remote from primary pci centres рус

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1. SFL ST , - Sigrun Halvorsen*, MD, PhD , HF Ullevl . , . , (Department of Cardiology, Oslo University Hospital HF Ullevl, Oslo, Norway) * : , HF Ullevl . , . , (Department of Cardiology, Oslo University Hospital HF Ullevl, NO-0407 Oslo, Norway). E-mail: [email protected]; [email protected] () , ST(ST). . , , , . , - ( ) , , . , 12 . , -, 24 , 7 . ST . ST , 90-120 (1, 2). ST, , , (3). , , - (, , , ), , ST. - , . , 120 . (1, 2). ,

2. ST, , : , , , . , - ST , , (4-6). , -. , ST ST . (7-9). , , (8, 9). , - , ,, , . (10). , . - 22 , , , (11). , . 1. 1. 6 , / / ( 3 ) - 24 (, , ) 6 ( >180 . . / >110 . .) 3. ; (12, 13). , , , , , , . , , - , 80-120 , (14, 15). NRMI , , - 120 . (16). , - , , (16). , , : 120 . ) ( ) (6 120 . 4. (17, 18). , , . 30 . . , , 30 ( -). - : ( (alteplase)) , r-PA ( (reteplase)) TNK-tPA ((tenecteplase)) (18). (Tenecteplase) , , . , ( . 1). 1. ST. Wijns, Kolh, Danchin (2). TIMI 3 - 30%-50%. (19). 5. , - . , , (1, 2). , , (20-24) ( 2). ( ). , . , -, ( ). . , 1,6 CAPITAL-AMI, 16,7 GRACIA-1 ( (Grup de Analisis de laCardiopatia Isquemica Aguda) ( 2) (18, 24). ASSENT-4 ( (Assessment of the Safety and Efficacy of a New Treatment Strategywith Percutaneous Coronary Intervention) (25), / . , , , (20-22). , -Desch (24), 1,1-16,7 , >70% 60 .) 6. (28). ST, , -. 2. , () ST. Halvorsen Huber (18). 7. ST ST ( ST), (), (29-30). , -. , , , , . ST , -, - , -, . ST (29). (Minnesota) , ST, 31 210 - . (Minneapolis), 2003. (31). -. , , 60 -, . , , 60 , ( ). - . , , , -, 30- (5,5% 5,6%; p=0,94), , , - (31). , ST - , . - 2004 . -, . (Oslo) ( . Ullevl), ( 3). . (Oslo), , - . , - , , 400 . -, , >100 . (Oslo) . . , 100 -, - . , >100 -, 8. ( ),

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