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1、急性心肌梗死行急诊介入治疗术中再灌注心律失常的临床分析DOT：10.3760/cma.j.issn.1671-0282.2014.10.018通信作者：张先林，Email：abc2007zhang@163.com【摘耍】目的分析急性ST段抬高型心肌梗死患者行急诊介入治疗(PCI)术中再灌注心律失常(RA)的临床特点。方法回顾性分析2008年1月至2013年9月的马鞍山市人民医院心内科行急诊介入治疗(PCT)的175例急性ST段抬高型心肌樓死患者的临床资料，根据PCI术中是否出现RA分为RA组和NRA组，对比
2、观察心肌酶及肌钙蛋白达峰值时间、抬高的ST段回落情况、住院时间，两组住院期间及术后1个月内心脏性死亡、休克、心力衰竭等不良事件发生率，以及比较术后第30天的两组心脏彩超结果。结果RA组卩CT时间窗显著早于NRA组，再灌注心律失常均得到有效控制。与NRA组比较，RA组有较高的ST段回落幅度，住院期间不良事件发生率较低；术后第30天时RA组具有较低的左室舒张期及收缩期内径及较高的左室射血分数(LVEF)值。结论急性心肌梗死患者行直接PCI术中出现再灌注心律失常，只要及时处理，就会预后良好。【关键词】急性心肌梗死
3、；介入治疗；再灌注心律失常AstudyofreperfusionarrhythmiasinpatientswithacutemyocardialinfarctionduringprimarypercutaneouscoronaryinterventionZhangXianlin,ZhangPing,WangYuesong,ShaoXuwu,WangXuezhong,DongXuebin.DepartmentofCardiology,MaanshanPeople，sHospital,Maanshan,2430
4、00ChinaCorrespondingAuthor:ZhangXianlin,Email:abc2007zhang@163.com[Abstract]ObjectiveToanalyzetheclinicalfeaturesofpatientswithacuteST-elevationmyocardialinfarctiontreatedwithpercutaneouscoronaryintervention(PCI)complicatingtointraoperativereperfusionarrhy
5、thmias(RA)•MethodsAtotalof175patientswithacuteST-elevationmyocardialinfarctionweretreatedwithPCIperformedfromJanuary2008toSeptember2013.AccordingtotheoccurrenceofRAfollowingPCI,thepatientsweredividedintoRAgroupandnon-RA(NRA)group.Comparisonofmyocardialenzy
6、mes,peaktroponin,theelevatedSTsegmentreturningback,lengthofhospitalstay,incidenceofadverseeventssuchascardiacdeath,shock,heartfailureduringhospitalizationandwithinamonthofpostoperativeperiodwascarriedout.betweengroups,andthefindingsfromechocardiographyonth
7、e30thdayafter卩CTwerealsocomparedbetweentwogroups.ResultsPCItimewindowinRAgroupwassignificantlyearlierthanthatofNRAgroup,andreperfusionarrhj^thmiawaseffectivelycontrolled.ComparedwithNRAgroup,RAgrouphadgreaterextentofSTsegmentnormalized,andtheincidenceofadv
8、erseeventswaslower・Onthe30thdayafterPCI,RAgrouphadshorterdurationofleftventriculardiastole,andreducedleftventricularcavitydimensionsandhigherejectionfraction(LVEF)value・ConclusionsReperfusionarrhythmiasoccuri
