急诊PCI术中再灌注心律失常的研究

Clinical research of reperfusion arrhythmia in patients with acute myocardial infarction during emergency percutaneous coronary interventions

目的探讨急性心肌梗死患者急诊行经皮冠状动脉介入术(PCI)中再灌注心律失常(RA)的临床特点。方法回顾性分析125例急性心肌梗死且急诊行PCI术治疗患者的临床资料。观察分析再灌注心律失常与梗死相关动脉(IRA)开通所需时间、IRA是否完全闭塞及梗死面积大小的之间的关系。结果 125例患者中85例发生RA(68%)。梗死6h内开通冠状动脉者再灌注心律失常发生率明显高于6～12h开通者(p<0.05)。完全闭塞组RA发生率总体发生率均显著高于次全闭塞组RA发生率(p<0.05)。广泛前壁心肌梗死与局限性心肌梗死RA的发生率无统计学差异(p>0.05)。结论 AMI患者直接PCI后RA发病率及严重程度与IRA病变程度、发病至开通IRA时间明确相关,与梗死面积无关。

Objective To investigate clinical features of reperfusion arrhythmia （RA） in acute myocardial infarction （AMI） patients during emergency percutaneous coronary interventions （PCI）. Methods Retrospective analyze the Clinical data of 125 AMI patients which received emergency PCI from Oct. 2010 to Oct. 2011 in the Cardiology Department of Second Hospital of Jilin University. Observing the relationship between RA and the opening time of the infarct-related artery （IRA）, the stenosis degree （partial or total） of IRA as well as the infarct size. Results RA occurs in 85 patients of the 125 cases（68%）. The RA incidence of the patients with operated PCI within 6h is significantly higher than that of the patients with operated PCI between 6h and 12h （p〈0.05）; Patients with total occlusion of coronary artery has a more higher RA Incidence than patients with partial occlusion （p 〈0.05）; The RA incidence between patients with limited myocardial infarction and patients with extensive anterior wall myocardial infarction has no significant difference （p〉0.05）. Conclusion The RA incidence and its＇ severity of AMI patients which received emergency PCI has certain relationship with the stenosis degree （partial or total） of IRA as well as the opening time of the IRA, while has no relationship with infarct size.