急性心肌梗死早期溶栓后再灌注心律失常及预后分析

Reperfusion Arrhythmia Effect on Prognosis after Early Thrombolysis in Patients with Acute Myocardial Infarction

目的:探讨急性心肌梗死早期溶栓后再灌注心律失常对预后的影响。方法:对确诊为急性心肌梗死的30例患者临床诊治资料进行回顾性分析。结果:30例患者中,冠状动脉再通25例,再通率83.33%;未通5例。再通病例中均出现再灌注心律失常,包括室上性心动过速6例,室性早博7例,短阵室速4例,室颤2例。高度房室传导阻滞3例,窦性心动过缓6例,死亡6例均为窦性心动过缓或高度房室传导阻滞。结论:早期溶栓仍然是抢救急性心肌梗死的首选措施,急性心肌梗死再灌注后缓慢心律失常死亡率明显高于快速心律失常(P<0.05)。

Objective： To explore reperfusion arrhythmia effect on prognosis after early thrombolysis in patients with acute myocardial infarction.Method： Data of 30 patients with acute myocardial infarction were analyzed retrospectively.Result： In 30 patients,25 patients with coronary artery reperfusion,the reperfusion rate was 83.33%.The cases that recanalization occurred in both of reperfusion arrhythmias,including 6 cases of supraventricular tachycardia,ventricular premature beats in 7 cases,a short array ventricular tachycardia in 4 cases,ventricular fibrillation in 2 cases.High degree atrioventricular block in 3 cases,sinus bradycardia in 6 cases,6 deaths were sinus bradycardia or high degree atrioventricular block.Conclusion： Early thrombolysis remains the first choice for emergency measures in acute myocardial infarction,after reperfusion arrhythmia the mortality rate was significantly higher than the slow tachyarrhythmia（P 0.05）.