急诊介入治疗对急性ST段抬高心肌梗死合并新发房颤转归的影响

The effect of emergency primary percutaneous coronary intervertion on the ST-segment elevation acute myocardial infarction combined with new atrial fibrillation outcome

目的:探讨急诊介入治疗对急性ST段抬高心肌梗死合并新发房颤转归的影响。方法:回顾性分析268例急性ST段抬高心肌梗死患者临床资料,新发房颤22例(8.2%),其中急诊介入治疗组10例,单纯药物治疗组12例,分析其房颤转归、临床特征以及住院并发症。结果:①急诊介入治疗组9例转复为窦性心律,1例为持续性房颤;单纯药物治疗组2例转复窦性心律,10例为持续性房颤,两组新发房颤转复窦性心律有统计学差异(P<0.01)。②两者基础临床特征无统计学差异(P>0.05),急诊介入治疗组出现心衰、低血压较单纯药物治疗组低,两者具有统计学差异(均P<0.05)。结论:急诊介入治疗可以显著提高急性ST段抬高心肌梗死合并新发房颤转复窦性心律的成功率,可能与其早期成功血运重建有关。

Objective： To investigate the effect of emergency primary percutaneous coronary intervention（PPCI） on the outcome of ST-segment elevation acute myocardial infarction combined with new atrial fibrillation.Methods： To make a restrospective analysis of the clinical data of 268 patients with acute ST-segment elevation myocardial infarction,and 22 patients with new atrial fibrillation（8.2%）.They were divided into 2 groups： Group1（received emergency PPCI,n=10） and Group 2（received medication treatment,n=12）,then anaylze the outcome of new atrial fibrillation,clinical characteristies and hospital complications.Results： ① 9 patients in group 1 turned to sinus rhythm,1 patient was persistent atrial fibrillation;while in group 2,2 patients turned to sinus rhythm,10 patients were persistent atrial fibrillation.There was statistical difference in sinus rhythm between the patients in the two groups（P0.01）.② There was no statistical difference in the basic clinical characteristics（P〈0.05）; the proportion of patients with heart failure and hypotension in group 1 was lower than those in group 2,which was of statistical difference（P〈0.05）.Conclusion： PPCI treatment may obviously increase the success rate of ST-segment elevation acute myocardial infarction combined with new atrial fibrillation turning to sinus rhythm,and it may be related with the earlier successful revascularization.