急性心肌梗死的再灌注心律失常临床分析

对采用溶栓治疗的37例急性心肌梗死患者同时进行Holter监测，以研究再灌注心律失常（RA）的过程和特点。再灌注组与未灌注组比较：两组心律失常总发生率均为100％；但加速性室性自主心律（AIVR）只发生于前者，其发生率为76．2％；前者窦性心动过缓的发生率为42．9％，显著比后者的12．5％要高，差异具有显著性（P＜0．05）；前者的室性心律失常在再灌注后的最初8h内发生较频繁，而后者无此现象。作者认为，RA的发生与心肌缺血时间无关，AIVR及一过性窦缓分别为预示再灌注和下壁梗死再灌注的可靠指标。大多数室性RA呈良性经过，不必常规应用抗心律失常药物，但个别患者仍应给予治疗。

CLINICAL ANALYSIS OF REPERFUSION ARRHYTHMIAS OF ACUTE MYOCARDIAL INFARCTION

The characteristics of reperfusion arrhythmias in 37 cases with acute myocardial infarction (AMI) who were treated with thrombolytic therapy were studied with Holter monitor. The reperfusion rate was 56. 8% (21/37). Reperfusion group was compared with nonreperfusion group. The results showed that: (1) total incidence of arrhythmias was 100% in two groups, but accelerated indioventricular rhythm (AIVR) only occurred in the reperfusion group (76. 2%), the incidence of sinus bradycardia was 42.9% in the reperfusion group (P<0. 05); (2) ventricular arrhythmias of the reperfusion group frequently occurred in 8 hours after thrombolytic therapy. The author tends to believe that occurence of the reperfusion arrhythmias is not correlated with duration of ischemia of myocardia, AIVR and temporary sinus bradycardia may be strong indexes of reperfusion of AMI and inferior or posterior infarction respectly. Most of ventricular reperfusion arrhythmias needn't to use anti-arrhythmia drugs, except some severe cases which may need be paid attentions and give them appropriate treatment.