急性心肌梗死后心脏性猝死的探讨

A study on sudden cardiac death after acute myocardial infarction

目的探讨急性心肌梗死后心脏性猝死(SCD)预防的关键环节。方法回顾56例急性心肌梗死后心脏性猝死患者的病历及随访资料,分析其原因或诱因、发病季节与发病时间、溶栓治疗与SCD的关系、致命性心律失常与SCD的相关性与预后等。结果严重心律失常为SCD的主要诱因,冬秋季多于春夏季,白天多于晚上,上午多于下午;住院治疗1周后、出院1周后为SCD的高发期,血钾偏低者多见,前壁多于下壁,未溶栓及溶栓未再通者SCD死亡率高。结论综合分析患者病例资料,密切观察病情变化,加强对关键环节的管理,对降低急性心肌梗死后心脏性猝死的发生具有积极的意义。

Objective To explore the cause of sudden cardiac death（SCD） after acute myocardial infarction（AMI）.Methods This study restrospectively reviewed the medical records of 56 patients suffered from SCD after AMI.the cause and incidence of the death,the relationship between thrombolytic therapy and SCD,correlation between thrombolytic therapy and SCD,and their prognosis with above factors were analyzed.Results Serious arrhythmia was the major cause of SCD.The morbidity was high in winter and autumn,and the incidence of SCD in the daytime/morning was higher than at night/afternoon.The occurrence was also high at 1 week after hospitalization or 1 week after the discharge.And patients with low serum potassium,also rate in anterior wall than inferior wall,High death rate was noted in patients without receiving thrombolytic therapy or without recanalization.Conclusion Comprehensive analysis of patients＇ clinical data,closely observation of AMI＇s changes,and strengthening of the management may reduce SCD after AMI.