急性下壁心肌梗死急诊PCI时起搏治疗的观察研究

目的分析急性ST段抬高型下壁心肌梗死（STEM）I急诊PCI时起搏治疗的疗效.方法选择急诊入院STEMI患者43名,分为试验组（临时起搏治疗）28例和对照组（非临时起搏治疗）15例.观察研究两组的一般资料、冠脉病变、血流情况、再灌注心律失常、并发症和预后情况.结果两组病例的一般资料无统计学意义（P〉0.05）;在冠脉近段病变时起搏治疗例数增多,与对照组比较有统计学意义（71.4%：20.0%,P〈0.05）,而在冠脉远段病变时暂不用起搏治疗,与试验组比较有统计学意义（40.0%：0,P〈0.05）;术中慢血流两组对比,试验组远多于对照组,两组有统计学意义（92.8%：26.7%,P〈0.05）;两组在新发心血管事件无统计学意义,而在再灌注心律失常方面有统计学意义（64.3%：13.3%,P〈0.05）.结论急性下壁心肌梗死时出现了严重的缓慢性心律失常及低血压,急诊PCI时主张临时起搏治疗;如果无上述情况发生,则无须临时起搏治疗。

The Effect of Pacing Therapy for Patients with Inferior STEMI during Primary PCI

Objective Tostudythe effect ofpacingtherapyfor patients with inferior STEMI during primary PCI.Methods Forty-three patients with inferior STEMI who underwent primary PCI were divided into two groups：the pacing therapeutic group（n = 30） and the non-pacing therapeutic group（n =15）.We observed the general data,the pathological changes of coronary artery,the blood flow,the reperfusion arrhythmia,the complication and the prognosis.Results There was no significant difference in general data between the two groups.But there was a significant difference in the near coronary artery pathological changes between the pacing therapeutic group and the non-pacing therapeutic group（71.4% vs 20.0%,P〈0.05）.There was a significant difference in the distal segment of coronary artery pathological changes between the pacing therapeutic group and the non-pacing therapeutic group（40.0%vs 0,P〈0.05）.There was a significant difference in the slowly blood flow between the pacing therapeutic group and the non-pacing therapeutic group（92.8%vs 26.7%,P〈0.05）.There was no significant difference in the incidence of newcardiovascular events between the two groups,but there was a significant difference in the incidence of reperfusion arrhythmia and complication（64.3% vs13.3%;7.1% vs 0,P〈0.05）.Conclusions When bradyarrhythmias and low-pressure occur in patients with acute inferior MI,the temporary pacing therpy duing primary PCI should be advocated.It is unnecessary to conduct pacing therpy if no bradyarrhythmias and low-pressure occur.