急性冠脉综合征缺血性J波与心律失常关系及替罗非班治疗的远期预后

目的：探讨急性冠脉综合征缺血性J波与心律失常关系及替罗非班治疗的远期预后。方法选取我院心内科2013年1月至2015年6月收治的急性冠脉综合征患者288例，根据心电图检查有无缺血性J波分为J波组38例与非J波组250例，观察两组患者心律失常的类型。所有急性冠脉综合征缺血性J波患者均接受介入治疗，根据有无使用替罗非班分为观察组与对照组，观察两组患者的近远期临床疗效。结果①J波组的室性心动过速、心室颤动发生率分别为39.47%(15/38)、21.05%(8/38)，非J波组分别为6.00%(15/250)、2.40%(6/250)，两组比较差异均有统计学意义(P<0.05)；②观察组术后30 d死亡率、心肌梗死率、靶血管血运重建(TVR)发生率分别为0(0/20)、5.00%(1/20)、5.00%(1/20)，对照组分别为22.22%(4/18)、33.33%(6/18)、33.33%(6/18)，两组比较差异均有统计学意义(P<0.05)；③观察组术后12个月死亡率、心肌梗死率、TVR发生率分别为0(0/20)、5.00%(1/20)、5.00%(1/20)，对照组分别为22.22%(4/18)、44.44%(8/18)、38.89%(7/18)，两组比较差异均有统计学意义(P<0.05)。结论急性冠脉综合征缺血性J波者心动过速、心室颤动的发生率较高，介入手术期间采用替罗非班能够有效降低近期及远期术后患者的死亡率及相关并发症。

Relationship between ischemic J wave and cardiac arrhythmias in patients with acute coronary syndrome and effects of tirofiban on long-term prognosis

Objective To investigate the relationship between ischemic J wave and cardiac arrhythmias in pa-tients with acute coronary syndrome and effects of tirofiban on long-term prognosis. Methods A total of 288 patients with acute coronary syndrome, who admitted to Department of Cardiology in our hospital from January 2013 to June 2015, were divided into J wave group (38 cases) and non J wave group (250 cases) according to electrocardiogram (ECG). The type of arrhythmia in the patients were observed. Syndrome of ischemic J wave patients with acute coronary syndrome underwent interventional treatment. According to using tirofiban or not, these patients were divided into study group and control group. The short and long term clinical effect two groups were observed. Results ①There were sig-nificant differences between observation group and control group in tachycardia 39.47%(15/38) vs 6.00%(15/250), P<0.05] and ventricular fibrillation (21.05%(8/38) vs 2.40%(6/250), P<0.05);②After 30 days of treatment, there were significant differences between observation group and control group in mortality 0 (0/20) vs 22.22%(4/18), P<0.05], myocardial infarction rate 5.00% (1/20) vs 33.33% (6/18), P<0.05], target blood vessel revascularization (TVR) oc-currence rates 5.00%(1/20) vs 33.33%(6/18), P<0.05];③After 12 months of treatment, there were significant differ-ences between observation group and control group in mortality 0%(0/20) vs 22.22%(4/18), P<0.05], myocardial in-farction rate 5.00% (1/20) vs 44.44% (8/18), P<0.05], incidence of TVR 5.00% (1/20) vs 38.89% (7/18), P<0.05]. Conclusion There are higher tachycardia, ventricular fibrillation occurrence rate in ischemic J wave patients with acute coronary comprehensive syndrome. Tirofiban can effectively reduce the short-term and long-term postoperative mortali-ty in patients and related complications during interventional procedures.