摘要
报道3例阻塞性睡眠呼吸暂停综合征(OSAS)病人,例1表现OSAS诱发心绞痛逐渐演变为急性心肌梗死,例2在急性心肌梗死过程中引起高度窦房、房室阻滞和心脏停搏,例3在急性心肌梗死基础上每有呼吸暂停发作便激发出室速和(或)室颤。治疗中,例2应用吗啡类可能加重了呼吸暂停程度;抗心律失常药和电复律效果在例3中表现欠佳。因此,OSAS诱发心梗并激发恶性心律失常的事件,在冠心病抢救中应引起充分认识和足够重视。
Background and Methods:Coronary heart disease (CHD) attack induced by obstructive sleep apnea syndrome (OSAS) is well-documented in retrospective study, but acute myocardial infarction (AMI) and malignant arrhythmia triggered in acute stage,especially in superacute stage,are less-known.Three patients with AMI and OSAS were observed. Results:The first one with angina pectoris confirmed before,resulted in AMI,owing to serious OSAS attack. The pain of myocardial in-farction was disappeared after morphine therapy but occurred again and was deteriorated during the apnea of OSAS set-up. The second patient,during AMI being developed,showed repeatedly high sino-atrial,atrio-ventricular block,sinus bradycar-dia and cardiac arrest (max.3.5 s) in the apnea of OSAS attack needing to implant pacemaker.The last,with AMI admit-ted to the hospital,malignant and fatal arrhythmia was triggered off by the middle-end of the longer apnea, which could not be completely controlled by anti-arrhythmia drugs and electrical defibrillation. These characteristics of OAS in AMI must be paid more attention to till now in clinical cardiology.
出处
《天津医药》
CAS
2000年第3期140-142,共3页
Tianjin Medical Journal
