急性ST段抬高性心肌梗死急诊静脉溶栓治疗灌注时间及再灌注性心律失常关系探究.doc

急性ST段抬高性心肌梗死急诊静脉溶栓治疗灌注时间及再灌注性心律失常关系探究 　　【摘要】 目的：研究不同时间窗内对急性ST段抬高性心肌梗死患者进行静脉溶栓治疗后心律失常发生情况，明确再灌注性心律失常与静脉溶栓治疗的关系。方法：对2012年1月-2016年1月在本院符合标准的114例ST段抬高性心肌梗死患者进行回顾，按照发病至溶栓治疗时间0～3、3～6、6～12 h分成三个治疗时间窗，收集其治疗时间内静脉溶栓后心律失常发生情况，分析其相关性。结果：三个时间窗对应的再灌注性心律失常的发生率分别为24.6%、8.8%和6.1%。再灌注性心律失常的常发生情况为：加速性室性自主心律17.5%，室性期前收缩8.8%。结论：静脉溶栓治疗开展的越早，再灌注心律失常的发生率越高，加速性室性自主心律可提示溶栓再灌注有效 【关键词】 急性ST段抬高性心肌梗死； 静脉溶栓； 时间窗； 再灌注性心律失常 【Abstract】 Objective：To study the conditions of arrhythmia patients with acute ST segment elevated myocardial infarction undergoing intravenous thrombolysis therapy at different times，and to clarify the relations between reperfusion-induced arrhythmia and intravenous thrombolysis therapy.Method：One hundred and fourteen patients qualified with ST segment elevated myocardial infarction admitted by the hospital from January 2012 to January 2016 were reviewed，three treatment intervals were divided according to the duration from the onset of attack to thrombolysis therapy at 0-3 hours， 3-6 hours and 6-12 hours，the occurrence of cardiac arrhythmia after intravenous thrombolysis with treatment duration was collected，and their dependences were analyzed.Result：The distribution rate for the incidence of reperfusion-induced arrhythmia at three time intervals was respectively 24.6%，8.8% and 6.1%.Common types and occurrence of reperfusion-induced arrhythmia were shown as follows：accelerated ventricular autonomous cardiac rhythm of 17.5%，and ventricular premature contraction of 8.8%.Conclusion：The earlier intravenous thrombolysis therapy，the higher of the incidence of reperfusion-induced arrhythmia will be， accelerated ventricular autonomic cardiac may indicate effective thrombolysis reperfusion. 【Key words】 Acute ST-segment elevated myocardial infarction； Intravenous thrombolysis； Time interval； Reperfusion-induced arrhythmia First-author’s address：Hezhou Peoples Hospital of Guangxi，Hezhou 542899，China doi：10.3969/j.issn.1674-4985.2017.07.017 随着人们饮食习惯的改变、生活节奏的加快和人口老龄化增多，我国急性