急性心肌梗死心房颤动出现的时间与临床特征的关系──附76例分析

Association between onset time of atrial fibrillation and clinical characteristics in acute myocardial infarction: analysis of 76 cases

目的：探讨急性心肌梗死（AMI）心房颤动发生的时间与患者临床特征的关系。方法：在1095例AMI连续病例中，76倒在发病后出现心房颤动，根据心房颤动发生的时间分为两组：心房颤动早发组（31例，发生在心肌梗死发病24小时内）和心房颤动晚发组（45例，发生在心肌梗死发病24小时后），比较两组临床特征的差异。结果：两组比较，心房颤动早发组下壁梗死的比率较高（P＜0．01），而心房颤动晚发组前壁梗死的比率较高（P＜0．01）。心房颤动晚发组Killip心功能大于或等于Ⅱ级的发生率及住院期病死率均高于早发组（P＜0．05）。结论：AMI心房颤动发生的时间与患者的临床特征及预后有关，可作为评估AMI病情及预后的参考指标。

Objective: To study the association between onset time of atrial fibrillation (AF) and clinical charac-terisitcs in acute myocardial infarction (AMI). Methods: Among 1o95 consecutive patients with AMI, 76 deve-loped AF after AMI. Patients with AF were divided into two groups according to onset time of AF: group l (n=3l,AF developed within 24 hours after AMI) and group 2: (n= 45, AF developed >24 hours after AMI). The clinicalcharacteristics of two group were compared. Results: The incidence of in ferior wall AMI was significantly higherin group 1 (P＜0. 01 ). The incidence of anterior wall AMI was significantly higher in group 2 (P＜0. 01). The inci-dence of congestive heart failure and the in-hospita1 mortality were higher in group 2 than group l (P<0. 05). Con-clusion: The onset time of AF may be regard as a useful parameter for evaluating the clinical characteristics andprognosis of patients with AMI.