摘要
目的本实验通过对急性心肌梗死再灌注治疗(急诊PCI)致再灌注心律失常发生率的研究,为临床对再灌注心律失常的预防及治疗提供依据。通过急性下壁心肌梗死急诊PCI术前应用阿托品,了解阿托品对窦性心动过缓、窦性停搏或窦房阻滞等缓慢性再灌注心律失常发生率的影响及临床意义。方法选取急性前壁和下壁心肌梗死就诊的患者共252例。对发病12小时内进行PCI术的患者根据急性下壁、前壁心肌梗死进行分组。分别计算出二组再灌注心律失常的发生类型及发生率。急性下壁心肌梗死患者92例,配对分成二组:一组冠脉开通前予阿托品1mg静推;另一组不予任何药物干预。分别观察二组再灌注心律失常的发生率。结果急性前壁心肌梗死室性心律失常发生71例次,严重缓慢性心律失常发生13例次;急性下壁心肌梗死实验组严重缓慢性心律失常发生15例次,室性心律失常发生12例次;对照组严重缓慢性心律失常发生33例次,室性心律失常发生9例次。结论急性前壁心肌梗死患者室性心律失常发生率显著高于急性下壁心肌梗死患者(P<0.01);急性下壁心肌梗死患者严重缓慢性心律失常发生率显著高于急性前壁心肌梗死患者(P<0.01)。阿托品前处理的急性下壁心梗患者严重缓慢性心律失常发生率显著低于未经阿托品前处理的急性下壁心肌梗死患者(P<0.01)。
Objective To investigate the incidence of the reperfusion arrhythmia （RA） in acute myocardial infarction （emergency PCI） and the preoperative atropine treatment to affect it. Methods Two hundrend and fifty-two AMI patients treated by PCI within 12 hours were divided into left anterior descending artery （LAD） group and right coronary artery （RCA） group. The 92 patients in RCA group were randomly redivided into atropine pretreatment group and no-atropine pretreatment group, and made a comparison on the incidences, frequency and the type of arrhythmia between the two subgroups. Resuits Ventricular arrhythmias （VA） occurred in 71 cases and 13 patients were deadly reperfusion arrhythmias in LAD group. Other 46 patients were in atropine experimental group,among them 12 cases were VA, 15 cases were slow arrhythmia （SA） . In the acute inferior myocardial infarction control group without atropine treatment VA was 9 cases and SA 33 cases. Conclusion The incidence of VP in LAD group was significantly higher than RCA group （P〈0.01） and the serious RA in RCA group was significantly higher than LDA group （P〈0.01）, but the serious RA in RCA group with the atropine pretreatment was significantly lower than without the atropine pretreatment group （P〈0.01）. So atropine pretreatment can effectively reduce application of pacemaker.
出处
《实用心脑肺血管病杂志》
2007年第11期815-818,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
急性心肌梗死
再灌注心律失常
阿托品
Acute myocardial infarction Reperfusion arrhythmia Atropine
