缺血后适应对急性心肌梗死PCI术中再灌注心律失常的疗效评估

Effect of ischemic postconditioning on reperfusion arrhythmia in patients with acute myocardial infartion during primary PCI

目的:探讨缺血后适应处理在急性心肌梗死急诊经皮冠状动脉介入(PCI)术中对再灌注心律失常的作用及临床应用价值。方法:将56例ST段抬高型急性心肌梗死行急诊PCI的患者随机分为常规处理组(29例)和缺血后适应组(27例)。术中出现再灌注心律失常后常规处理组予以药物或临时起搏处理,缺血后适应组立即予以球囊低压扩张多次使罪犯血管造成短暂再通/闭塞。观察两组不同处理方法对再灌注心律失常的转复效果。结果:缺血后适应组再灌注心律失常的例数明显低于常规处理组(3/27vs12/29,P<0.05),术后心电图ST段回落值两组之间差异无统计学意义(P>0.05)。结论:缺血后适应处理能快速终止急诊PCI术中的再灌注心律失常。

Objective：To explore whether ischemia postconditioning during emergency percutaneous intervention（PCI）can terminate reperfusion arrhythmia.Methods：Fifty-six patients with acute myocardial infarction undergoing primary PCI were randomized into the conventional treatment group（n=29）and postconditioning group（n=27）.If reperfusion arrhythmia occurred,ischemic postconditioning（1 minute reperfusion followed by 1 minute occlusion）was conducted in postconditioning group and routine drug management or temporary pacing was taken in coventional group.Results：The number of reperfusion arrhythmia in postconditioning group was significantly lower than that in conventional treatment group（3/27 vs 12/29,P〈0.05）.There were no significant differences in ST segment regression between the two groups after PCI.Conclusion：The results suggest that ischemic postcoditioning can terminate reperfusion arrhythmia in patients with acute myocardial infarction undergoing emergency PCI.