急性冠状动脉综合征

急性冠状动脉综合征
急性冠状动脉综合征
	冠状动脉阻塞示意图
类型	冠状动脉疾病、coronary syndrome[*]
分类和外部资源
医学专科	心脏病学
ICD-10	I24.9
MedlinePlus	[1]
eMedicine	emerg/31
MeSH	D054058
	[编辑此条目的维基数据]

急性冠状动脉综合征（acute coronary syndrome，ACS）又称急性冠脉综合征^[1]^[2]，是一组由急性心肌缺血引起的临床综合征，包括不稳定型心绞痛、急性心肌梗死、心源性猝死。

ACS成因是冠状动脉内粥样斑块破裂、表面破损或出现裂纹，继而出血和血栓形成，引起冠状动脉不完全或完全梗阻，以致心肌供血严重不足的临床综合征。其临床表现为不稳定型心绞痛、急性心肌梗死或心源性猝死。最常见的症状是胸部有挤压般的疼痛，常放射至左臂或下颌角点（gonion），并伴有恶心和出汗。

ACS分型在中国的占比为：急性心肌梗死约占65％（ST段抬高型心肌梗死^[3]（ST elevation myocardial infarction, STEMI）约50％，非ST段抬高型心肌梗死^[4]（non ST elevation myocardial infarction, NSTEMI）约15％-20%）以及不稳定型心绞痛（unstable angina）约占25%-35％^[5]^[6]。

相对于急性冠脉综合征的，称为慢性冠脉综合征，两者皆属于冠状动脉疾病^[7]^[8]^[9]。

参考

^ 弗伦.急性冠脉综合征心电图[M].北京大学医学出版社,2007.
^ 杨新春.急性冠脉综合征基础与临床[M].人民军医出版社,2003.
^ 中国医师协会急诊医师分会, 国家卫健委能力建设与继续教育中心急诊学专家委员会, 中国医疗保健国际交流促进会急诊急救分会. 急性冠脉综合征急诊快速诊治指南(2019) [J] . 中华急诊医学杂志, 2019, 28(4) : 421-428. DOI: 10.3760/cma.j.issn.1671-0282.2019.04.003.
^ 李毅,韩雅玲. 2023 ESC急性冠脉综合征管理指南解读[J]. 中华心血管病杂志,2023,51(12)：1263-1267. DOI:10.3760/cma.j.cn112148-20230920-00175
^ Han XN, Qiao SB, Ge JB, Han YL, Chen JY, Yuan ZY, Yu B, Jiang J, Huo Y. Long-term follow-up of antithrombotic management patterns in patients with acute coronary syndrome in China. J Geriatr Cardiol. 2020 May;17(5):246-255. doi: 10.11909/j.issn.1671-5411.2020.05.008. PMID 32547607; PMCID: PMC7276310.
^ Si-Yi Li, Ming-Gang Zhou, Tao Ye, Lian-Chao Cheng, Feng Zhu, Cai-Yan Cui, Yu-Mei Zhang, Lin Cai. Frequency of ST-segment elevation myocardial infarction, non-ST-segment myocardial infarction, and unstable angina: results from a Southwest Chinese Registry. Rev. Cardiovasc. Med. 2021, 22(1), 239–245. https://doi.org/10.31083/j.rcm.2021.01.103
^ 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines
^ Juhani Knuuti, William Wijns, Antti Saraste et al. , ESC Scientific Document Group , 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes: The Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC), European Heart Journal, Volume 41, Issue 3, 14 January 2020, Pages 407–477, https://doi.org/10.1093/eurheartj/ehz425
^ Ueng KC, Chiang CE, Chao TH, et al. 2023 Guidelines of the Taiwan Society of Cardiology on the Diagnosis and Management of Chronic Coronary Syndrome [published correction appears in Acta Cardiol Sin. 2023 Nov;39(6):946]. Acta Cardiol Sin. 2023;39(1):4-96. doi:10.6515/ACS.202301_39(1).20221103A

外部链接

[1] 弗伦.急性冠脉综合征心电图[M].北京大学医学出版社,2007.

[2] 杨新春.急性冠脉综合征基础与临床[M].人民军医出版社,2003.

[3] 中国医师协会急诊医师分会, 国家卫健委能力建设与继续教育中心急诊学专家委员会, 中国医疗保健国际交流促进会急诊急救分会. 急性冠脉综合征急诊快速诊治指南(2019) [J] . 中华急诊医学杂志, 2019, 28(4) : 421-428. DOI: 10.3760/cma.j.issn.1671-0282.2019.04.003.

[4] 李毅,韩雅玲. 2023 ESC急性冠脉综合征管理指南解读[J]. 中华心血管病杂志,2023,51(12)：1263-1267. DOI:10.3760/cma.j.cn112148-20230920-00175

[5] Han XN, Qiao SB, Ge JB, Han YL, Chen JY, Yuan ZY, Yu B, Jiang J, Huo Y. Long-term follow-up of antithrombotic management patterns in patients with acute coronary syndrome in China. J Geriatr Cardiol. 2020 May;17(5):246-255. doi: 10.11909/j.issn.1671-5411.2020.05.008. PMID 32547607; PMCID: PMC7276310.

[6] Si-Yi Li, Ming-Gang Zhou, Tao Ye, Lian-Chao Cheng, Feng Zhu, Cai-Yan Cui, Yu-Mei Zhang, Lin Cai. Frequency of ST-segment elevation myocardial infarction, non-ST-segment myocardial infarction, and unstable angina: results from a Southwest Chinese Registry. Rev. Cardiovasc. Med. 2021, 22(1), 239–245. https://doi.org/10.31083/j.rcm.2021.01.103

[7] 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines

[8] Juhani Knuuti, William Wijns, Antti Saraste et al. , ESC Scientific Document Group , 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes: The Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC), European Heart Journal, Volume 41, Issue 3, 14 January 2020, Pages 407–477, https://doi.org/10.1093/eurheartj/ehz425

[9] Ueng KC, Chiang CE, Chao TH, et al. 2023 Guidelines of the Taiwan Society of Cardiology on the Diagnosis and Management of Chronic Coronary Syndrome [published correction appears in Acta Cardiol Sin. 2023 Nov;39(6):946]. Acta Cardiol Sin. 2023;39(1):4-96. doi:10.6515/ACS.202301_39(1).20221103A

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分类	ICD-10：I24.9 MeSH：D054058
外部资源	eMedicine：emerg/31 Patient UK：急性冠状动脉综合征