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目的 观察急性心肌梗死后存活心肌对急性期严重心律失常的影响。方法 采用硝酸甘油介入单核素或双核素方法测定 36 6例首次急性心肌梗死患者的存活心肌 ,根据临床症状和ST T波改变确定有无心肌缺血 ,分为心肌存活组、无心肌存活组及症状性心肌缺血亚组、无心绞痛症状亚组。比较存活心肌组与无存活心肌组及其心肌缺血亚组的总心律失常、快速性 (室上性、室性 )和缓慢性心律失常的发生率。结果 存活心肌组室上性心律失常、室性早搏和室上性心动过速的发生率明显高于无存活心肌组 ;心肌缺血亚组的心律失常更为显著 (P <0 .0 5 ) ;各组缓慢性心律失常发生率的差异无显著性 (P >0 .0 5 )。结论 存活心肌更易促发心律失常 ,其心电稳定性可能受心肌缺血的影响
Objective To observe the effect of viable myocardium after acute myocardial infarction on acute arrhythmia in acute phase. Methods The surviving myocardium of 366 patients with first acute myocardial infarction was measured by single or dual nuclide intervention with nitroglycerin. According to the clinical symptoms and ST T wave changes, the presence or absence of myocardial ischemia was divided into myocardial survival group, no myocardial survival group And symptoms of myocardial ischemia subgroup, no symptoms of angina subgroups. The incidences of total arrhythmia, rapid (supraventricular and ventricular), and bradyarrhythmia were compared between surviving and non-viable myocardium and their ischemic subgroups. Results The incidence of supraventricular arrhythmia, ventricular premature ventricular tachycardia and supraventricular tachycardia was significantly higher in surviving myocardium than that in non - viable myocardium. The arrhythmia was more significant in the subgroup of myocardial ischemia (P <0.05). There was no significant difference in the incidence of bradyarrhythmia in each group (P> 0.05). Conclusions Surviving myocardium is more likely to trigger arrhythmia and its ECG stability may be affected by myocardial ischemia