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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 the clinical features of reperfusion arrhythmias (RA) in patients undergoing acute percutaneous coronary intervention (PCI) in acute myocardial infarction. Methods A retrospective analysis of 125 cases of acute myocardial infarction and emergency PCI in the treatment of patients with clinical data. The relationship between reperfusion arrhythmia and infarction related artery (IRA) opening time, IRA complete occlusion and infarct size were observed and analyzed. Results Of the 125 patients, 85 developed RA (68%). The incidence of reperfusion arrhythmia was significantly higher in patients with coronary artery opening within 6h after infarction than in patients with 6-12h opening (p <0.05). The overall incidence of RA in the complete occlusion group was significantly higher than that in the subtotal occlusion group (p <0.05). There was no significant difference in the incidence of extensive anterior myocardial infarction and localized myocardial infarction (p> 0.05). Conclusion The incidence and severity of RA after PCI in AMI patients are closely related to the severity of IRA, the onset of IRA, and the infarct size.