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目的:探讨保护性临时起搏对急性下壁心肌梗死急诊经皮冠状动脉介入治疗再灌注反应的影响。方法:入选急性下壁心肌梗死且成功完成急诊经皮冠状动脉介入治疗住院患者203例,其中未行临时起搏患者158例,列为非起搏组;行保护性临时起搏患者共45例,列为保护性起搏组。观察2组患者的一般临床特征、冠状动脉病变特点、再灌注前心率、再灌注前后血压水平、再灌注后恶性室性心律失常的发生情况。结果:保护性起搏组再灌注低血压发生率较非起搏组有增高趋势(40.00%∶30.38%);保护性起搏组再灌注后恶性室性心律失常发生率较非起搏组也有增高趋势(6.67%∶2.53%),但2组比较均差异无统计学意义(P>0.05)。再灌注前保护性起搏组收缩压与非起搏组比较差异无统计学意义,但再灌注后保护性起搏组收缩压降低明显(P<0.05)。结论:临时起搏对再灌注反应无明显保护性作用。
Objective: To investigate the effect of protective temporary pacing on reperfusion after percutaneous coronary intervention in patients with acute inferior myocardial infarction. Methods: A total of 203 hospitalized patients with acute inferior myocardial infarction who were successfully treated with percutaneous coronary intervention were enrolled. Among them, 158 cases were untreated temporarily and were enrolled as non-pacing group. A total of 45 patients with protective temporary pacing , As a protective pacing group. The general clinical features, coronary lesions, heart rate before reperfusion, blood pressure before and after reperfusion, and the incidence of malignant ventricular arrhythmias after reperfusion were observed in two groups. Results: The rate of reperfusion hypotension in protective pacing group was higher than that in non-pacing group (40.00%, 30.38%). The incidence of malignant ventricular arrhythmia in protective pacing group after reperfusion was also higher than that in non-pacing group (6.67% vs2.53%), but there was no significant difference between the two groups (P> 0.05). There was no significant difference in the systolic pressure between the protective pacing group and the non-pacing group before reperfusion, but the systolic pressure of the protective pacing group decreased significantly after reperfusion (P <0.05). Conclusion: Temporary pacing has no protective effect on reperfusion.