标题：急性冠脉综合征缺血性J波与心律失常关系及替罗非班治疗的远期预后

      作者：夏敏 1，施亚明 2，吴春阳 2，唐娟 1，施国富 2
    (盐城市第三人民医院电生理室 1、心内科 2、，江苏 盐城 224001)

      卷次： 2016年27卷13期

      【摘要】 目的 探讨急性冠脉综合征缺血性 J波与心律失常关系及替罗非班治疗的远期预后。方法 选取我
院心内科2013年1月至2015年6月收治的急性冠脉综合征患者288例，根据心电图检查有无缺血性 J波分为 J波组
38例与非 J波组250例，观察两组患者心律失常的类型。所有急性冠脉综合征缺血性 J波患者均接受介入治疗，根
据有无使用替罗非班分为观察组与对照组，观察两组患者的近远期临床疗效。结果 ① J波组的室性心动过速、
心室颤动发生率分别为 39.47% (15/38)、21.05% (8/38)，非 J波组分别为 6.00% (15/250)、2.40% (6/250)，两组比较差
异均有统计学意义(P<0.05)；②观察组术后30 d死亡率、心肌梗死率、靶血管血运重建(TVR)发生率分别为0 (0/20)、
5.00% (1/20)、5.00% (1/20)，对照组分别为22.22% (4/18)、33.33% (6/18)、33.33% (6/18)，两组比较差异均有统计学意
义(P<0.05)；③观察组术后 12个月死亡率、心肌梗死率、TVR发生率分别为 0 (0/20)、5.00% (1/20)、5.00% (1/20)，对
照组分别为22.22% (4/18)、44.44% (8/18)、38.89% (7/18)，两组比较差异均有统计学意义(P<0.05)。结论 急性冠脉
综合征缺血性 J波者心动过速、心室颤动的发生率较高，介入手术期间采用替罗非班能够有效降低近期及远期术后
患者的死亡率及相关并发症。

      【关键词】 急性冠脉综合征；缺血性 J波；心律失常；替罗非班；疗效

      【中图分类号】 R541.4 【文献标识码】 A 【文章编号】 1003—6350（2016）13—2099—03


Relationship between ischemic J wave and cardiac arrhythmias in patients with acute coronary syndrome and
effects of tirofiban on long-term prognosis.
XIA Min 1, SHI Ya-ming 2, WU Chun-yang 2, TANG Juan 1, SHI Guo-fu 2.
Electrophysiology Room 1, Department of Cardiology 2, the Third People's Hospital, Yancheng 224001, Jiangsu, CHINA

【Abstract】 Objective To investigate the relationship between ischemic J wave and cardiac arrhythmias in pa-
tients with acute coronary syndrome and effects of tirofiban on long-term prognosis. Methods A total of 288 patients
with acute coronary syndrome, who admitted to Department of Cardiology in our hospital from January 2013 to June
2015, were divided into J wave group (38 cases) and non J wave group (250 cases) according to electrocardiogram
(ECG). The type of arrhythmia in the patients were observed. Syndrome of ischemic J wave patients with acute coronary
syndrome underwent interventional treatment. According to using tirofiban or not, these patients were divided into study
group and control group. The short and long term clinical effect two groups were observed. Results ① There were sig-
nificant differences between observation group and control group in tachycardia [39.47% (15/38) vs 6.00% (15/250), P<
0.05] and ventricular fibrillation (21.05% (8/38) vs 2.40% (6/250), P<0.05); ② After 30 days of treatment, there were
significant differences between observation group and control group in mortality [0 (0/20) vs 22.22% (4/18), P<0.05],
myocardial infarction rate [5.00% (1/20) vs 33.33% (6/18), P<0.05], target blood vessel revascularization (TVR) oc-
currence rates [5.00% (1/20) vs 33.33% (6/18), P<0.05];③After 12 months of treatment, there were significant differ-
ences between observation group and control group in mortality [0% (0/20) vs 22.22% (4/18), P<0.05], myocardial in-
farction rate [5.00% (1/20) vs 44.44% (8/18), P<0.05], incidence of TVR [5.00% (1/20) vs 38.89% (7/18), P<0.05].
Conclusion There are higher tachycardia, ventricular fibrillation occurrence rate in ischemic J wave patients with acute
coronary comprehensive syndrome. Tirofiban can effectively reduce the short-term and long-term postoperative mortali-
ty in patients and related complications during interventional procedures.

      【Key words】 Acute coronary syndrome; Ischemic J wave; Arrhythmia; Tirofiban; Therapeutic effect
·论 著·
6350.2016.13.012