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目的:对急性心肌梗死(AMI)再灌注后出现的特殊临床表现进行分析。方法:50例AMI患者经静脉溶栓后行冠状动脉造影显示TIMI血流3级。结果:再灌注后有48例胸痛迅速缓解,2例胸痛突然加重;44例出现心律失常;40例出现一过性低血压;8例出现一过性ST段抬高。结论:冠状动脉血管再通后绝大部分患者胸痛迅速缓解,且有心律失常发生,一小部分患者可出现一过性胸痛加重;一过性低血压也比较常见,可能与多种因素有关;ST段反常性抬高可能是心肌再灌注的指标;溶栓后应进行持续心电和血压监测。
Objective: To analyze the special clinical manifestations after acute myocardial infarction (AMI) reperfusion. Methods: Fifty patients with AMI underwent coronary angiography after intravenous thrombolysis, showing TIMI grade 3. Results: 48 cases of chest pain were relieved immediately after reperfusion, 2 cases of chest pain suddenly aggravated, 44 cases of arrhythmia, 40 cases of transient hypotension and 8 cases of transient ST elevation. Conclusions: Most of the patients with recanalization of the coronary artery rapidly relieve chest pain and arrhythmia occurs. A small proportion of patients may experience transient chest pain. One-off hypotension is also more common and may be related to many factors. Anomalous elevation of ST segment may be an indicator of myocardial reperfusion. Thrombolytic therapy should be followed by continuous ECG and blood pressure monitoring.