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1、不稳定型心绞痛和非ST段抬高心梗的治疗AcuteManagementofUA/NSTEMIAnti-IschemicTherapyOxygen,bedrest,ECGmonitoringNitroglycerin-BlockersACEinhibitorsUA,unstableangina;NSTEMI,non-ST-segmentelevationmyocardialinfarction;ECG,electrocardiogram;ACE,angiotensin-convertingenzyme.BraunwaldE,etal.JAmCo
2、llCardiol.2000;36:970-1062.AntithromboticTherapyAntiplatelettherapyAnticoagulanttherapyPossible ACSAspirinAspirin+IVHeparin+IVPlatelet GPIIb/IIIaAntagonistDefiniteACSWithInvasiveStrategy(Catheterization/PCI)orHighRisk(IIa)*ClopidogrelAspirin+SQLMWH*orIVHeparinLikely/Definit
3、e ACSClopidogrel*ClassIIa:enoxaparinpreferredoverUFHunlessCABGplannedwithin24hours.ACC,AmericanCollegeofCardiology;AHA,AmericanHeartassociation;ACS,acutecoronarysyndrome;PCI,percutaneouscoronaryintervention;SQLMWH,subcutaneouslowmolecular-weightheparin;IV,intravenous.Braunw
4、aldE,etal.JAmCollCardiol.2000;36:970-1062.ACC/AHAClassIRecommendationsforAntithromboticTherapy*17.16.5*PlaceboASA05101520Patients(%)UnstableAngina25.011.0*ASA01020303.31.9*ASA0123411.89.4*ASA051015AcuteMIAspirininAcuteCoronarySyndromes*P<.0001DeathorMI*P=.003Reocclusion*P=.
5、012MI*P<.001DeathN=3973995134198587860085878600MI,myocardialinfarction;ASA,acetylsalicylicacid;RISC,ResearchonInStabilityinCoronaryarterydisease.RISCGroup.Lancet.1990;336:827-830.RouxS,etal.JAmCollCardiol.1992;19:671-677.ISIS-2.Lancet.1988;2:349-360.PlaceboPlaceboPlaceboAsp
6、irininAcuteCoronarySyndromes12.93.9*ASA05101511.93.3*ASA05101512.96.2*ASA0510152.21.3*ASA00.511.522.5UA/NSTEMIPrimary PreventionStable Angina*P<.0001 MI*P=.0003 MI*P=.008 DeathorMI*P=.012 DeathorMIN=1103411037155178279276118121MI,myocardialinfarction;ASA,acetylsalicylicacid
7、;RISC,ResearchonInStabilityinCoronaryarterydisease;ISIS-2,SecondInternationalStudyofInfarctSurvival.PHS.NEnglJMed.1989;321:129-35.RidkerPM,etal.AJC.1991;114:835-839.CairnsJA,etal.NEnglJMed.1985;313:1369-1375.TherouxP,etal.NEnglJMed.1988;319:1105-1111.PlaceboPlaceboPlaceboPl
8、aceboPatients(%)IndirectComparisonsofASADosesonVascularEventsinHigh-RiskPatients*O
