急性心梗行直接冠脉介入术中再灌注性心律失常的临床特点及预后的影响  

Clinical characteristics of reperfusion arrhythmia during direct percutaneous coronary intervention in AMI patients and its influence on prognosis

作　　者：刘鸿玲[1] LIU Hong-ling(Special Ward, Central Hospital of Jiamusi City, Jiamusi, Heilongjiang, 154002, China)

机构地区：[1]佳木斯市中心医院特需病房,黑龙江佳木斯154002

出　　处：《心血管康复医学杂志》2017年第1期94-97,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨急性心肌梗死(AMI)行直接经皮冠状动脉介入治疗(PCI)术中再灌注性心律失常的特点及对预后的影响。方法:回顾性分析2013年1月~2014年12月在我院行直接PCI的180例AMI患者的病历资料。结果:112例患者发生再灌注性心律失常,发病率为62.22%,与年龄相关(r=0.614,P=0.026),年龄越大越易发生再灌注性心律失常;其中单支血管病变患者再灌注心律失常的发生率明显高于多支病变患者(69.17%比48.33%,P=0.021)。右冠状动脉梗死患者再灌注心律失常发生率明显高于左前降支组、左回旋支组(71.67%比61.67%比53.33%),两两比较差异均有统计学意义(P<0.05或<0.01)。6h内开通冠状动脉者再灌注心律失常发生率明显低于6~12h开通者(47.62%比66.67%,P=0.025)。再灌注性心律失常组在住院期间和术后6个月患者的死亡、再梗死及卒中与无再灌注性心律失常组比较差异无统计学意义(P均>0.05)。结论:急性心肌梗死行直接经皮冠状动脉介入治疗术中再灌注性心律失常率与血管病变支数、梗死血管类型及冠脉开通时间有关。Objective.. To explore clinical characteristics of reperfusion arrhythmia （RA） during direct percutaneous coronary intervention （PCI） in patients with acute myocardial infarction （AMI） and its influence on prognosis. Methods.. Clinical data of 180 AMI patients undergoing direct PCI in our hospital from Jan 2013 to Dec 2014 were retrospectively analyzed. Results： RA rate in 112 patients was 62.22% and Ws correlated with age （r = 0. 614, P = 0. 026）, the age is more older , the RA rate is more higher. Compared with multi - vessel coronary disease patients, there was significant rise in incidence rate of RA （48.33% vs. 69.17%, P = 0. 021） in single - vessel disease patients; compared with left anterior descending group and left circumflex group, there was significant rise in incidence rate of RA （61.67% vs. 53.33% vs. 71.67%） in right coronary artery group, and there was significant difference between any two groups, P%0.05 all. Compared with patients with coronary recanalization within 64 12h, there was significant reduction in incidence rate of RA （66.67% vs. 47.62%, P = 0. 025） in those within 6h. There were no significant difference in incidence rates of death, reinfarction and stroke during hospitalization and six months after PCI between RA group and no RA group, P〈0.05 all. Conclusion.. The occurrence of reperfusion arrhythmia in patients with acute myocardial infarction during direct percutaneous coronary intervention is associated with number of diseased vessels, infarct vascular type and coronary recanalization time.

关 键 词：心肌梗死 血管成形术 气囊 冠状动脉 心律失常 心性 

分 类 号：R542.22[医药卫生—心血管疾病]