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[心肌梗死急性期原发性室性心动过速的发生时间]

[Time of occurrence of primary ventricular tachycardia in the acute phase of myocardial infarction].

作者信息

Juillard A, Bouajina A, Cristofini P, Lowenstein W, Gay J, Barrillon A, Gerbaux A

出版信息

Arch Mal Coeur Vaiss. 1984 Aug;77(8):880-6.

PMID:6435567
Abstract

The hour of day of primary ventricular tachycardia (VT) in the acute phase of myocardial infarction was studied in 63 consecutive patients without cardiac failure or antiarrhythmic therapy, admitted to hospital less than 6 hours after the onset of chest pain. There were 19 women and 44 men, with an average age of 63 years. The site of infarction was anterior in 23 cases, posterior in 34 cases and circumferential in 6 cases. The cardiac rhythm was analysed from the 6th hour following the onset of chest pain for 4 days, using a HP 98220 A computerised analyser CPK levels were measured daily. Ventricular tachycardia occurred in 73% of cases with no significant difference between daytime (18 patients) and night time (28 patients). The patients developing VT did not differ from the remainder with respect to age, sex, or site of ECG changes, but peak CPK levels were significantly higher than in patients without VT. The risk of VT decreased slowly as the interval from the onset of chest pain increased and fell practically to zero after the 40th hour. Diurnal and nocturnal VT were independent of age, sex or site of infarct. However, nocturnal VT correlated independently of the time of onset of chest pain to high values of CPK. There was no difference with respect to age, sex, location of infarct or incidence of ventricular tachycardia between infarcts with pain starting during the day, and infarcts with pain starting at night. However, when the pain started during the day, the peak CPK was significantly higher and there were significantly more attacks of nocturnal ventricular tachycardia.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对63例胸痛发作后不到6小时入院、无心力衰竭且未接受抗心律失常治疗的连续患者,研究了心肌梗死急性期原发性室性心动过速(VT)发生的时段。其中女性19例,男性44例,平均年龄63岁。梗死部位在前壁23例,后壁34例,环周6例。从胸痛发作后第6小时起4天内,使用惠普98220 A计算机分析仪分析心律,每天测量肌酸磷酸激酶(CPK)水平。73%的病例发生室性心动过速,白天(18例患者)和夜间(28例患者)之间无显著差异。发生室性心动过速的患者在年龄、性别或心电图改变部位方面与其余患者无差异,但CPK峰值水平显著高于未发生室性心动过速的患者。随着胸痛发作后时间间隔增加,室性心动过速风险缓慢降低,在第40小时后几乎降至零。昼夜室性心动过速与年龄、性别或梗死部位无关。然而,夜间室性心动过速与胸痛发作时间无关,独立地与CPK高值相关。白天开始疼痛的梗死和夜间开始疼痛的梗死在年龄、性别、梗死部位或室性心动过速发生率方面无差异。然而,当疼痛在白天开始时,CPK峰值显著更高,夜间室性心动过速发作明显更多。(摘要截短于250词)

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