心肌缺血后适应在急诊PCI术中抗心律失常效应的临床研究  

Anti- arrhythmia effect of myocardial ischemia postconditioning during emergency PCI in patients with acute myocardial infarction

作　　者：魏渝鉴 陈晓栋[2] 娄彬[2] 沈建平[2] 于圣永[2] 胡政力[2] 龚觉晓[2] 谷明林[2] 吴溧兴[2] 王新东[2] 路达琦[2] 

机构地区：[1]南京医科大学第一临床医学院,江苏南京210029 [2]南京中医药大学附属中西医结合医院江苏省中西医结合医院心血管内科,江苏南京210028

出　　处：《中国急救医学》2015年第12期1103-1107,共5页Chinese Journal of Critical Care Medicine

基　　金：基金项目：江苏省卫生厅科技项目“江苏省心律失常临床调研”（KFSN201407-12）

摘　　要：目的观察急性心肌梗死（AMI）急诊经皮冠状动脉介入治疗（PCI）术中心肌缺血后适应（SIP）对再灌注心律失常的抗心律失常效应及手术时间影响。方法262例ST段抬高型急性心肌梗死（STEMI）行急诊PCI的患者随机分为常规处理组（常规PCI组，132例）和缺血后适应组（MIP组，130例），分别对再灌注心律失常采用常规处理和MIP处理，观察两组不同处理方法对再灌注心律失常的抗心律失常效果，并记录心律失常持续时间及总手术时间。结果MIP组再灌注心律失常的持续时间均明显短于常规PCI组，总手术时间亦短于常规处理组。结论急诊PCI术中的再灌注心律失常通过MIP处理能够在更短的时间内得到终止，并能缩短急诊PCI的总手术时间。Objective Exploring the anti - arrhythmia effect of ischemia postconditioning during emergency percutaneous intervention （PCI）. Methods 262 patients who were undergoing primary PCI with acute myocardial infarction were enrolled and randomized into the conventional curing group （n = 132） or postcondioning group （n = 130）. If reperfusion arrhythmia occurred, ischemia postconditioning （one minute reperfusion follow by one minute occlusion） was taken in postconditioning group, and drug or temporary pacing was taken in conventional group. The duration of types of arrhythmia and total time of PCI operation were recorded. Results There was no significant difference in ST segment regression between the two groups after PCI. The duration of arrhythmia and total time of PCI operation in postconditioning group were absolutely shorter than those in conventional curing group. Conclusion Comparing with conventional methods, ischemia postconditioning could more quickly terminate reperfusion arrhythmia in patients with acute myocardial infarction undergoing emergency PCI. Simultaneously, total time of PCI procedure would be also shortened.

关 键 词：急性心肌梗死(AMI) 心肌缺血后适应(MIP) 经皮冠状动脉介入治疗(PCI) 再灌注心律失常 

分 类 号：R542.22[医药卫生—心血管疾病]