CAJ | 학술논문

目的：观察急性ST抬高心肌梗死（STEMI）患者直接经皮冠脉介入术（PCI）发生室颤的相关因素。方法选择2010年1月~2014年10月直接PCI的STEMI患者325例，分为发生室颤(VF)和无室颤两组，分析发生室颤的相关因素。结果325例STEMI患者在PCI术中发生室颤24例，24例患者出现室颤时均需要电除颤复律，其中9例患者应用了抗心律失常药物（胺碘酮、利多卡因）。两组患者PCI术中均无死亡。两组患者在年龄、性别、高血压、糖尿病、吸烟、LVEF、血浆CK峰值、梗死部位、从发病至IRA开通时间上比较差异无统计学意义。VF组无复流发生率、低血钾发生率较对无VT组升高（P＜0.05）。院内死亡3例，其中VF组1例，无VF组2例。结论对于STEMI患者，应注意预防无复流及低血钾的发生。
목적：관찰급성ST태고심기경사（STEMI）환자직접경피관맥개입술（PCI）발생실전적상관인소。방법선택2010년1월~2014년10월직접PCI적STEMI환자325례，분위발생실전(VF)화무실전량조，분석발생실전적상관인소。결과325례STEMI환자재PCI술중발생실전24례，24례환자출현실전시균수요전제전복률，기중9례환자응용료항심률실상약물（알전동、리다잡인）。량조환자PCI술중균무사망。량조환자재년령、성별、고혈압、당뇨병、흡연、LVEF、혈장CK봉치、경사부위、종발병지IRA개통시간상비교차이무통계학의의。VF조무복류발생솔、저혈갑발생솔교대무VT조승고（P＜0.05）。원내사망3례，기중VF조1례，무VF조2례。결론대우STEMI환자，응주의예방무복류급저혈갑적발생。
Objective To observe the relative factors of Ventricular Fibrillation(VF) in patients with ST-Elevation Myocardial Infarction (STEMI)undergoing primary percutaneous coronary intervention(PCI).Methods A total of 325 consecutive patients with STEMI who underwent primary PCI in General Hospital of Chinese PLA Beijing Military from January 2010 to October 2014. They were devided into 2 groups based on the patients with or without VF.All clinical data and characteristics of coronary lesion were compared between the two groups.Result Twenty-four(7.4%) patients occurred VF among these 325 STEMI patients when they were undergoing PCI. All these patients needed electric defibrillation when VF occurred.Nine of these 24 patients received antiarrhythmic drugs(amiodarone or lidocaine). No mortality was observed in all of the patients.There was no statistically significant difference in clinical data(age, gender, hypertension, diabetes mellitus,smoking, left ventricular ejection fraction),myocardial enzyme peak, infarction location,time from symptom onset to infarction related artery opening between the two groups(all p>0.05). VF group had a higher incidence of no-reflow phenomenon (20.8% vs 8.3%,p<0.05) and a lower serum potassium[(3.1±0.2) mmol/L vs (4.2±0.3)mmol/L, p<0.01] than non-VF group.Three patients died in hospital:1 in VF group and 2 in non-VF group.Conelusion No-reflow phenomenon and hypokalemia are related to VF in patients with STMI undergoing primary PCI.Physicians should pay more attention to the prevention of no-reflow phenomenon and hypokalemia during PCI.