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1 Circulation Journal Vol. 72, Suppl. IV,
2 PCI CCU STEMI CABG ST ST1 EBM ST ST ST ST ST ST 1 EBMEvidence-Based Medicine 1444 Circulation Journal Vol. 72, Suppl. IV, 2008
3 ACS ST T ST CLBBB ST ACS ST ACS 12 CPK 24 ST ST Q Q C a a b ACSacute coronary syndrome STEMIST-elevation myocardial infarction ST PCIpercutaneous coronary intervention CABGcoronary artery bypass grafting CCUcoronary care unit A B STEMICCU Circulation Journal Vol. 72, Suppl. IV,
4 B B 100 / 119 AED STEMI AED AED chain of survival C chain of survival B STEMI FAXC a B STEMI automated external defibrillatoraed 2AED B STEMIMONA B STEMI MONA PCI STEMI PCI CABG A STEMI PCI B STEMI C 1446 Circulation Journal Vol. 72, Suppl. IV, 2008
5 3 1 C STEMI X 3 1V4R 2 3 Door-to-needle time : 30 Door-to-balloon time : 90 Door-to-needle time Door-to-balloon time 12 THyperacute TT R ST / Q V 4 R :CKCK-MBH-FABP intimal flap X Circulation Journal Vol. 72, Suppl. IV,
6 Killip2 ACS C ACS C V R B C C C C C C C C C 3 C 50% 50% 90mmHg <2h 24h 46h 612h 1224h 2472h >72h * H-FABP* * CK-MB CK * 1448 Circulation Journal Vol. 72, Suppl. IV, 2008
7 B a C C C mmhg mmhgbpm bpm C B C AmgC mg mg PCI ACT C a tpapro-ukmutant tpa aptt C STEMI A C mmhgc / C C C C STEMIPCI TIMI door-to-needle time PCI door-to-balloon time.mvst A A Circulation Journal Vol. 72, Suppl. IV,
8 a C ST B C STACS A A B / mmhg 45 primary PCI A primary PCI B a PCI primary PCIB B bprimary PCI B ckillip primary PCIB a ac bc cc primary PCI C primary PCIC PCI primary PCI b primary PCI B primary PCI C PCI A 1450 Circulation Journal Vol. 72, Suppl. IV, 2008
9 STEMI ST 1mm PCI facilitated PCI facilitated PCI PCI 90 CABG PCI STEMI ST 1mm PCI 24 PCI PCI PCI *STT Circulation Journal Vol. 72, Suppl. IV,
10 a PCI B a STEMI PCI B PCI B PCI B B STEMI ST A B bb A STEMI B ab STEMIPCI.g/kg/ PCI B b PCI B C PCI ac tpapro-ukmutant tpa 1452 Circulation Journal Vol. 72, Suppl. IV, 2008
11 STEMICCU CCU PCI CABG BC C CCU PCI PCI CCU J J J-JJ B a mg B.mEq/L.mg/dLC meq/ g a.-.mg/kg C Primary VF 6 / B J J J-JJ <mmhg Circulation Journal Vol. 72, Suppl. IV,
12 1 / 150J200J 360J K>4.0mEq/LMg>2.0mg/dL 1 125mg mg/kg 3 20mg/ 2 200J 1 125mg 2 IABP PCl 3K>4.0mEq/LMg>2.0mg/dL mg/kg 1 <90mmHg 100J 2 >90mmHg a. 125mg 10 b. 50J 3 / J 50J mg 4 12mg 1 210mg 0.125mg/kg 0.1ml/kg1mg/kg mg B J <mmhg B J a mg B IABP PCl B.mEq/L.mg/dL CmEq/ g /minqtc C a..mg/kg B 1454 Circulation Journal Vol. 72, Suppl. IV, 2008
13 ac JJ J b..mgmg C ac mg..mg/kg.ml/ kgmg/kg bc.-mg mg mg cstemi C dc ac batpc mg mg mg c C B STEMI bpm C Mobitz a.mobitz. QTc STEMIHis-Purkinje His-Purkinje B B C Circulation Journal Vol. 72, Suppl. IV,
14 C C a C C C C C Forrester s subset7 subset PCWP mmhgci.// ACE subset PCWP>mmHgCI.// /min / m2 2.2 mmhg 18 subset PCWP mmhgci.// subset PCWP mmhgci.// intra-aortic balloon pumpingiabp percutaneous cardiopulmonary support systempcps mmhgc C C a C C C IABP B C C C B IABP B PCI CABG B B 1456 Circulation Journal Vol. 72, Suppl. IV, 2008
15 B 8STEMI 4 C C mmhg mmhg IABP C C ACE A C LVEF ACE A C B IABP B C PCI CABG A PCI CABG B C a Swan-Ganz C PCI CABG B V R B C C C IABP C C 5 B CABG B B CABG B B CABG C a CABG B Circulation Journal Vol. 72, Suppl. IV,
16 / CPAP/ NPPV 35mg IABP >100mmHg 70100mmHg < 70mmHg NTG g/kg/ ISDN0.22.0g/kg/ g/kg/ 13g/kg/ 0.520g/kg/ 0.520g/kg/ g/kg/ ACE ARB PCICABG CPAP NTG NPPV ISDN IABP ACE PCI ARB CABG A B 1V 4 R ST 0.1mv 2akinesis dyskinesis 3 10mmHg 5mmHg 4 noncompliant 5 C mmHg 4Kussmaul 5 99m Tc B IABP C PCI CABG B primary PCI C 1458 Circulation Journal Vol. 72, Suppl. IV, 2008
17 1% 13% % > % 3.9% primary PCI :2435 :114 : :1 14 : :1 14 thrill - v thrill+ - 29%47% Pulseless Electrical Activity 5mm a PCI ST C A B B C a C B C XCT/MRIMRA C PT-INR A A STEMI B V R B a V V B Circulation Journal Vol. 72, Suppl. IV,
18 CK CK-MB B a B B B B a I-BMIPP C A A A B A CABG C CABG B a B B B PCI CABG B STEMI A B a 1460 Circulation Journal Vol. 72, Suppl. IV, 2008
19 C B C B B B B a I-BMIPP C MRI C A a BNP B A B B C a B STEMI C a C STEMI C Circulation Journal Vol. 72, Suppl. IV,
20 12METs STEMI 9ST * *STEMI. PCI STEMI STEMI 78 S T E M I m : 200m : 200m : m 1600Kcal6g 1600Kcal 6g : : : : : : : KillipCK U/LCK <U/L 1462 Circulation Journal Vol. 72, Suppl. IV, 2008
21 1: 2: 120/ 40 / 3: 4ST : 1mm ST ST. 5 : 20mmHg 30mmHg 2 STEMI /B B C ACE LVEF ICD METs / Circulation Journal Vol. 72, Suppl. IV,
22 9 / 16g 130ml LDL 100mg/dL BMI 22kg/m 2 BMI HbA1c6.5% mg/ 112 LDL 100mg/dL LDL ACE LVEF40% ACE ACE ARB a 20mg/a 1464 Circulation Journal Vol. 72, Suppl. IV, 2008
110木村班DG念校.indd
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