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目的 :探讨急性心肌梗死 (AMI)时发生心房纤颤 (AF)的临床和预后的意义。方法 :分析 44 6例急性心肌梗死患者 ,并发心房纤颤者 3 5例 ,根据房颤发生时间分为 AF1组 (于 AMI后 2 4小时内发生 16例 )和 AF2组 (于 AMI后 2 4小时后发生 19例 ) ;合并窦性心律者 411例。回顾性分析三组临床特征及住院病死率。结果 :窦性心律组患者年龄明显小于 AF1组 (P <0 .0 5 )和 AF2组 (P <0 .0 5 ) ;AF1组患者下壁心梗的发生率明显高于窦性心律组或 AF2组 ;AF2组前壁心梗的发生率明显高于 AF1组 ;3 5例并发 AF者住院病死率、心力衰竭和心源性休克的发生率均明显高于窦性心律组。结论 :AMI并发 AF患者住院病死率高于窦性心律者 ,AMI患者 AF发作时间对评价心脏状态是一个有价值的参考
Objective: To investigate the clinical and prognostic significance of atrial fibrillation (AF) in acute myocardial infarction (AMI). Methods: A total of 446 patients with acute myocardial infarction were enrolled in this study. Thirty-five patients with atrial fibrillation were divided into AF1 group (16 cases within 24 hours after AMI) and AF2 group 19 cases occurred after hours); 411 patients with sinus rhythm. Three groups of clinical characteristics and in-hospital mortality were retrospectively analyzed. Results: The age of sinus rhythm group was significantly lower than that of AF1 group (P <0.05) and AF2 group (P <0.05). The incidence of inferior myocardial infarction in AF1 group was significantly higher than that of sinus rhythm group or AF2 group. The incidence of anterior myocardial infarction in AF2 group was significantly higher than that in AF1 group. The incidence of hospital mortality, heart failure and cardiogenic shock were significantly higher in 35 AF patients than in sinus rhythm group. Conclusions: In-hospital mortality in patients with AMI complicated with AF is higher than that in patients with sinus rhythm. AF onset time in patients with AMI is a valuable reference for evaluating cardiac status