急性心肌梗死患者心房颤动的临床和预后意义

The significance of clinic and prognosis of atrial fibrillation in acute myocardial infarction

目的 :探讨急性心肌梗死 (AMI)时发生心房纤颤 (AF)的临床和预后的意义。方法 :分析 44 6例急性心肌梗死患者 ,并发心房纤颤者 3 5例 ,根据房颤发生时间分为 AF1组 (于 AMI后 2 4小时内发生 16例 )和 AF2组 (于 AMI后 2 4小时后发生 19例 ) ;合并窦性心律者 411例。回顾性分析三组临床特征及住院病死率。结果 :窦性心律组患者年龄明显小于 AF1组 (P <0 .0 5 )和 AF2组 (P <0 .0 5 ) ;AF1组患者下壁心梗的发生率明显高于窦性心律组或 AF2组 ;AF2组前壁心梗的发生率明显高于 AF1组 ;3 5例并发 AF者住院病死率、心力衰竭和心源性休克的发生率均明显高于窦性心律组。结论 :AMI并发 AF患者住院病死率高于窦性心律者 ,AMI患者

Objective:To explore The significance of clinic and prognosis of atrial fibrillation(AF) in the acute myocardial infarction(AMI) Methods:In all 466 AMI patients,there are 35 patients with AF.And according to the occurrence of AF with in or later 24 hour of AMI,35 patients were divided into two groups:the early onset group named AF1(16 cases) and the later onset group named AF2(19 cases).So the 411 patients left were AMI with sinus rhythm.The clinical character and mortality rate in hospital of the three groups were analysed respedtively Results:The age of group of AMI with sinus rhythm was significantly yonger than that of the other two groups(P<0 01);The incidence rate of posterior AMI in group AF1 was significantly higher than that in the other two groups;but the incidence rate of anterior AMI and death in group AF2 were significantly higner than that in group AF1;the mortality in hospital,the incidence rate of heart failure and cardial shock in the 35 AMI with AF patients were significantly higher than that in the group of AMI with sinusrhythm Conclusion:The AMI patients with AF have a higher mortality rate than the patients without AF.And the time of AF occuring in AMI patients is a valuable referrence to evaluate the heart's state and prognosis