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缺血心肌恢复其血流灌注可引起严重的节律紊乱,即再灌注性心律失常(Reperfusion Arrhythmias,RA)。这一病理过程,临床上常发生在一过性冠脉痉挛、血栓溶解或冠脉搭桥术后,不仅是冠心病患者猝死的主要原因,也是影响心肌梗塞再通疗法疗效的严重并发症。在冠脉溶栓疗法成功的病例中,室颤发生率可高达70%。因此,随临床上再通疗法的普遍应用,RA亦倍受关注。本文旨在对其发生机理、影响因素及防治措施作一综述。RA的生理生化基础缺血心肌再灌注时,心肌不仅存在缺血所致损伤的不均一性,而且加上了再灌注引起的进一步损伤和/或恢复的不均一性,这种存在于缺血区内及缺血区与非缺血区之间的血液供应及代谢在时空上的不均一性(Heterogeneity)为RA的发生提供
Reperfusion Arrhythmias (RA) can be caused by the recovery of ischemic myocardium by perfusion of blood stream. This pathological process, clinically often occurs in transient coronary spasm, thrombolysis or coronary artery bypass grafting, not only is the main cause of sudden death in patients with coronary heart disease, but also affect the efficacy of recanalization of myocardial infarction serious complications. In cases of successful coronary thrombolysis, the incidence of VF can be as high as 70%. Therefore, with the widespread use of clinical recanalization, RA is also much attention. The purpose of this paper is to review its mechanism, influencing factors and prevention and cure measures. Physiological and biochemical basis of RA, myocardial ischemia reperfusion, myocardial ischemia not only exist the damage caused by non-uniformity, but also with the reperfusion caused further damage and / or recovery of heterogeneity, which exists in ischemia Heterogeneity of blood supply and metabolism between regions and between ischemic and non-ischemic regions provides for the occurrence of RA