课件：第讲：心肌梗死内科学第版.ppt

* 药名 单次给药 维持给药 肾上腺素?? 5~50 μg?? 0.01~0.3 μg/(min×kg) 去甲肾上腺素??2~50 μg?? 0.01~0.3 μg/(min×kg) 异丙肾上腺素??1~10 μg?? 0.01~0.1 μg/(min×kg) 间羟胺?? 50~100 μg?? 0.5~5.0 μg/(min×kg) 多巴胺?? 50~200 μg?? 2.0~10μg/(min×kg) 米力农?? 20~70 μg/kg?? 0.2~1.0 μg/(min×kg)?? 硝酸甘油?? 50~100μg? ? 0.2~2 μg/(min×kg) 硝普钠?? ? 0.2~8 μg/(min×kg) 常用药物的用法（了解） * STEMI治疗 其他治疗 Β受体阻滞剂 ACEI及ARB 他汀类 抗凝治疗 硝酸酯类药物 钙拮抗剂：不宜使用 洋地黄：24h之内一般不使用，如并发快速房颤可用 极化液和镁剂 * STEMI治疗 恢复期的处理 并发症的处理 右心室心肌梗死的处理 NSTEMI的处理 * 急性心肌梗死住院病死率（%） * 二级预防 A. aspirin , anti-anginal therapy B. beta-blocker, blood pressure control C. cholesterol lowing, cigarettes quiting D. diet control, diabetes treatment E. education, exercise * 我的联系方式： TelEmail:guibinhe67@ THANK YOU SUCCESS * * 可编辑 * 2005年7月2日23时，扮演一代伟人毛泽东的著名特型演员古月因突发心肌梗死抢救无效而不幸去世。。。 2006年12月20日上午9点，著名相声演员马季先生因突发心肌梗死去世。。。 2007年6月23日下午，著名笑星、相声表演艺术家侯耀文因突发心肌梗死而猝死家中。。 * AMI Stats are difficult to pin down. On the screen are the stats from the most recent AHA publication and web posting. “The estimated incidence of MI (ICD/9 410) is 565,000 new attacks and 300,000 recurrent attacks annually. (Atherosclerosis Risk in Communities [ARIC, 1987-2000], NHLBI) The average age of a person having a first heart attack is 65.8 for men and 70.4 for women. (ARIC and CHS, NHLBI)” Heart Disease and Stroke Statistics — 2004 Update, American Heart Association Data from the National Registry of Myocardial Infarction (NRMI) 4 Quarterly Report differentiate between arrival diagnosis and discharge diagnosis. Upon arrival, an ECG with evidence of ST-segment elevation is present in 26% of discharged AMI patients. Including ECG evidence of STEMI on the first ECG and adding in the presence of STEMI on subsequent ECGs there are 35% of ECGs that have evidence of STEMI. There were 75% of the AMIs in NRMI 4 that were non-Q-wave vs Q-wave an