急性心肌梗死再灌注心律失常的临床分析

目的:探讨急性心肌梗死(AMI)再灌注心律失常(Reperfusion Arrhythmia,RA)的临床特点及其对患者预后的影响。方法:回顾分析107例溶栓治疗的AMI患者RA的发生情况及预后。结果:107例患者中74例冠状动脉再通,前壁和下壁两组的再通率无明显差异,分别为56/77和18/30(X2=0.3095,P>0.05);RA的发生情况没有差异(X2=0.084,P>0.05);RA多自行消失,快速型和缓慢型RA的持续时间没有差异(t=1.79,P>0.05)。前壁AMI和下壁AMI发生快速型和缓慢型RA的情况有差异(X2=30.59,P<0.05),前壁AMI以快速型为主,下壁AMI以缓慢型为主。结论:AMI溶栓治疗后RA中各种快速、缓慢性心律失常均可出现,但出现严重心律失常的情况比较少见,最常见的为一过性快速室性心律失常,对此不必特殊处理。但应严密监测,作好相应的抢救准备以防出现严重心律失常导致患者猝死。

Clinical Analysis of Reperfusion Arrhythmia in Acute Myocardial Infarction

Objective:To investigate the clinical feature and the effect on prognosis of reperfusion arrhythmia(RA) in acute myocardial infraction(AMI).Method:Retrospective study the RA ratio and prognosis in 107 AMI patients after intravenous thrombolysis.Result:The ration of recanalization of infarction-related coronary artery was 74/107 judged by clinical evidence,there was no significant difference between anterior wall group and inferior wall group(X2=0.3095,P>0.05),the recanalization ratio was 56/77 and 18/30 respectively.There was no difference between the two groups in RA ratio(X2=0.084,P>0.05).Most RA terminated without treatment.There was no difference of the duration of RA between the fast and slow type RA(t=1.79,P>0.05).The majority type of RA between anterior wall group and inferior wall group were various(X2=30.59,P<0.05).The majority type RA of anterior wall group were fast while that of inferior wall group were slow.Conclusion:Various kinds of arrhythmia could be caused by reperfused after intravenous thrombolysis.Transient fast ventricular arrhythmia are common but serious cardiac arrhythmias are seldom.It should be monitored closely instead of special handling,we should prepare in case of serious cardiac arrhythmias causing sudden death.