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1、急性心肌梗死伴新发心房纤颤临床研究［摘要］目的研究探讨急性心肌梗死（AMI）伴新发心房纤颤（AF）的临床特点。方法回顾性分析344例急性心肌梗死患者住院期间的资料，其中新发房颤患者53例（AF组）,未发生房颤者291例（NAF组），AF组按新发AF持续时间分为AF1组23例（心肌梗死24h内发生AF者），AF2组30例（心肌梗死24h后发生AF者）。比较AF组和NAF组之间的年龄、并发症、CK-MB峰值、心功能（K订lp分级）、死亡率以及NAF组和AF1组、AF2组之间心肌梗死部位病变血管情况等因素的对比。结果AF组老年患者
2、多于NAF组（P<0.01）,AF伴有高血压病、糖尿病者高于NAF组（PC0.01）,AF组CK-MB峰值、心力衰竭发生率、死亡率显著高于NAF组（P<0.01）,AF组冠状动脉多支病变的发生率较NAF组髙（P<0.05）,AF1组下壁AMI发生率高于NAF组和AF2组（P<0.05）,AF2组前壁AMI发生率高于AF1组（P<0.05）。结论高龄、伴发高血压、糖尿病、梗死面积及多支血管病变是AMI并新发AF的危险因素，AF发生时间与AMI梗死部位相关，AMI并新发AF者严重并发症多，预后差，应给予早期积极干预。［关键词］急
3、性心肌梗死；新发心房纤颤；危险因素；预后［中图分类号］R542.2+2［文献标识码］A［文章编号］1674-4721(2012)07(b)-0033-03ClinicalanalysisofacutemyocardialinfarctionwithnewcasesofatrialfibrillationMAShuqiDepartmentofCardiology,ShekouPeople"sHospitalofShenzhenCityinGuangdongProvince,Shenzhen518067,China［Abstra
4、ct］ObjectiveTostudytheclinicalfeaturesofacutemyocardialinfarction(AMI)withnewcasesofatrialfibrillation(AF)・MethodsThreehundredandforty-fourcasesofacutemyocardialinfarctionpatientsinhospitalwerestudied,thepatientsweredividedintonewcasesof53patientswithatrialfibrilla
5、tion(AFgroup)and291patientswithnoatrialfibrillation(NAFgroup),AFgroupwasdividedintotwosubgroupsaccordingtotheonsettimeofAF,inAF1group,AFdevelopedwithin24hoursaftertheonsetAMI,inAF2group,AFdevelopedmorethan24hoursaftertheonsetAMI,theage,complications,CK~MBpeak,andca
6、rdiacfunction(Killphierarchical)andmortalitywerecontrastedbetweenAFgroupandtheNAFgroup,partsofmyocardialinfarctionandvascularlesionsofthefactorswerecontrastedbetweenNAFgroupandAF1,AF2group.ResultsTheadvancedageofpatientsinAFgroupwashigherthanthatinNAFgroup(P<0.01),
7、AFhypertensiondisease,diabetesinAFgroupweremorethantheNAFgroup(P<0.01),CK-MBpeak,incidenceofheartfailureanddeathrateinAFgroupwashigherthanthoseoftheNAFgroup(P<0.01),coronaryarterymultivesseldiseaseincidenceofAFgroupwashigherthanthatofNAFgroup(P<0.05).ThelowerwallAM
8、IincidenceinAF1groupwashigherthanthatofNAFgroupandAF2group(P<0.05),theanteriorwallAMIincidenceinAF2groupwashigherthanthatofNAFgroupandAF1group(P<
