急诊冠状动脉介入治疗后再灌注心律失常的临床分析

Clinical analysis of emergency coronary after interventional reperfusion arrhythmia

目的探讨急性心肌梗死患者行急诊冠状动脉介入治疗后再灌注心律失常的发生特点,以便减少严重心律失常的发生率,改善患者预后及生活质量。方法对该院2009年1月至2012年5月收治的147例急性心肌梗死患者行急诊冠状动脉介入治疗后再灌注心律失常的资料进行分析。结果 147例患者中有62例出现再灌注心律失常,梗死相关动脉为左前降支(LAD)33例(LAD组),左回旋支(LCX)7例(LCX组),右冠状动脉(RCA)22例(RCA组)。LAD组快速型心律失常发生率高于RCA组(P<0.05);RCA组缓慢型心律失常发生率高于LAD组(P<0.05)。梗死相关动脉开通时间小于6h发生心律失常43例,而大于6h发生心律失常19例;心律失常主要发生于急性心肌梗死后梗死相关动脉较早开通者。结论急性心肌梗死急诊冠状动脉介入治疗后再灌注心律失常发生率高,心律失常的类型与梗死相关动脉有相关性,其发生率与再灌注时间有关。

Objective To explore the characteristics of the reperfusion arrhythmia after acute myocardial infarction （AMI） pa- tients underwent emergency coronary interventional therapy,in order to reduce the incidence of serious arrhythmia,and improve the prognosis and quality of life. Methods Clinical data of 147 patients from January 2009 to May 2012 with acute myocardial infarction occurrence reperfusion arrhythmia after underwent emergency coronary interventional treatment were analyzed. Results In 147 ca- ses,62 cases of reperfusion arrhythmia occurred. Infarct related artery for the left anterior descending branch （LAD） 33 patients （LAD group ） ,left circumflex artery （LCX） 7 cases （LCX group ） after surgery,the right coronary artery（RCA） 22 cases （RCA group）. The tachyarrhythmia in LAD group was higher than RCA group（P〈0.05） ;the bradyarrhythrnia in RCA group was higher than LAD group （P〈0.05）. Opening of the infarct related artery%6 h arrhythmia had 43 cases occurred,and 〉6 h arrhythmia had 19 cases occurred;Arrhythmia after acute myocardial infarction occurred mainly in infarct related artery opened earlier. Conclusion AMI occurrence reperfusion arrhythmia after underwent emergency coronary interventional treatment have high incidence,there is a correlation between the arrhythmia type and infarct related artery,also has a correlation between incidence and reperfusion time.