急性心肌梗死患者PCI治疗后再灌注心律失常发生率及与其临床特征的相关性研究  

A Correlation Study on Incidence Rate of Reperfusion Arrhythmia after PCI Treatment with Clinical Features in Patients with Acute Myocardial Infarction

作　　者：周湘 邹剑杰[1] 罗晓鸣[1] 闫玉九 薛丽 沙小梅 杨慧 ZHOU Xiang;ZOU Jian-jie;LUO Xiao-ming;YAN Yu-jiu;XUE Li;SHA Xiao-mei;YANG Hui(Department of Cardiology,Panzhihua Hospital of Integrated Traditional Chinese and Western Medicine,Panzhuhua,Sichuan 617000,China)

机构地区：[1]攀枝花市中西医结合医院心内科

出　　处：《解放军医药杂志》2019年第8期39-43,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：四川省科技厅项目(14JC0082)

摘　　要：目的分析急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)治疗后再灌注心律失常(RA)发生率及与其临床特征的相关性。方法通过对我院2016年4月—2018年4月就诊收治的96例经PCI治疗后AMI患者的临床资料做回顾性分析,记录RA的发生率,分析RA发生的危险因素。结果本组发生RA44例(45.83%)。年龄≥45岁、伴随高血压与糖尿病、发病至进行PCI治疗时间<6h、手术时间在0.5~1h、动脉压力波形异常、病变血管血流TIMI分级为0级、梗死部位为下壁、病变血管数量多的AMI患者发生RA的概率高于对照组(P<0.05)。伴随高血压与糖尿病、发病至进行PCI治疗时间<6h、动脉压力波形异常、病变血管血流TIMI分级为0级、梗死部位为下壁、病变血管数量为双支或多支是影响AMI患者经PCI治疗后发生RA的独立危险因素(P<0.05)。结论在经PCI治疗后AMI患者中,伴随高血压与糖尿病、发病至进行性行PCI治疗时间<6h、动脉压力波形异常、病变血管血流TIMI分级为0级、梗死部位为下壁、病变血管数量为双支或多支可增加发生RA的风险,及时做好应对措施、减少再灌注的损伤,对改善患者预后具有重要意义。Objective To analyze correlation between incidence rate of reperfusion arrhythmia(RA)after percutaneous coronary intervention(PCI)treatment with clinical features in patients with acute myocardial infarction(AMI).Methods Clinical data of 96 AMI patients treated with PCI admitted during April 2016 and April 2018 was retrospectively analyzed,and incidence rate of RA in all patients after treatment was recorded,and relevant risk factors of RA in patients with AMI after PCI treatment were analyzed.Results Among 96 patients with AMI after PCI treatment,44 patients(45.83%)had RA.Probability of RA in patients with age equal or more than 45 years old,combination of hypertension and diabetes,time from onset to PCI treatment less than 6 h,operation time within 0.5-1 h,abnormal arterial pressure waveform,grade 0 lesion vascular blood flow TIMI classification,infarction area in inferior wall and larger number of lesion blood vessels was significantly higher than that in control group(P<0.05).Combination of hypertension and diabetes,time from onset to PCI treatment less than 6 h,abnormal arterial pressure waveform,grade 0 lesion vascular blood flow TIMI classification,infarction area in inferior wall,double or more than two numbers of lesion blood vessels were independent risk factors affecting incidence rate of RA in AMI patients after PCI treatment(P<0.05).Conclusion Combination of hypertension and diabetes,time from onset to PCI treatment less than 6 h,abnormal arterial pressure waveform,grade 0 lesion vascular blood flow TIMI classification,infarction area in inferior group,double or more than two numbers of lesion blood vessels may increase risk of RA development,and therefore timely corresponding treatments and reduction of reperfusion damage are of great significance for improving prognosis of patients.

关 键 词：急性心肌梗死 经皮冠状动脉介入治疗 心肌再灌注 心律失常 危险因素 

分 类 号：R542.22[医药卫生—心血管疾病]