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目的通过分析急性心肌梗塞并发心房纤颤患者的冠状动脉病变的特点，探讨冠脉病变的不同程度对急性心肌梗塞时房颤发生的影响。方法回顾性分析了急性心肌梗塞并发房颤的患者（８７例），与同期无房颤发生的心肌梗塞患者（６００例）的冠状动脉造影、急诊ＰＴＣＡ和静脉溶栓的临床资料。结果两组患者的梗塞相关血管发生的部位差别无显著性。而三支血管病变的发生率房颤组（３１．４％）显著高于非房颤组（１８．８％）；梗塞相关血管的再通率非房颤组（６９．６％）显著高于房颤组，在房颤组中，早期组的冠脉再通率（７３．６％）又显著高于后期组（１６．６％）。结论冠脉血管的多支病变和灌注不良与急性心肌梗塞后房颤的发生密切相关。急性心肌梗塞后早期发生房颤者冠脉血管再通率高，提示ＡＭＩ发病后早期房颤的发生可能与再灌注损伤有关。
Objective To analyze the characteristics of coronary lesions in patients with acute myocardial infarction complicated by atrial fibrillation and to explore the effect of different degrees of coronary lesions on the occurrence of atrial fibrillation in patients with acute myocardial infarction. Methods The clinical data of coronary angiography, emergency PTCA and intravenous thrombolysis were retrospectively analyzed in 87 patients with acute myocardial infarction complicated by atrial fibrillation and in patients with myocardial infarction without atrial fibrillation in the same period (600 patients). Results There was no significant difference in infarct-related angiogenesis between the two groups. The incidence of three-vessel disease in AF group (31.4%) was significantly higher than that in non-AF group (18.8%); the recanalization rate of infarction-related vessels was significantly higher in non-AF group (69.6% In the AF group, in the AF group, the rate of coronary recanalization (73.6%) in the early group was significantly higher than that in the late group (16.6%). Conclusions Multi-vessel disease and perfusion of coronary vessels are closely related to the occurrence of atrial fibrillation after acute myocardial infarction. Acute myocardial infarction in patients with early atrial fibrillation coronary recanalization rate, suggesting that the incidence of early AMI after onset may be related to reperfusion injury.