Objective To explore the clinical characteristics of reperfusion arrhythmias (RA) in patients with ST segment el‐evation myocardial infarction(STEMI) after percutaneous coronary intervention (PCI) .Methods A total of 148 STEMI patients undergoing emergency PCI in our hospital from January 2010 to December 2014 were selected and divided into the RA group (71 cases) and non‐RA group (NRA group ,77 cases) according to whether RA occurring during PCI .The RA situation was observed . The relation between the infarct related artery and RA was analyzed ,the fall back situation of elevated ST segment was observed , the levels of cardiac troponin I (TnI) and creatine kinase isoenzyme MB (CK‐MB) and echocardiographic findings were compared between the two groups .Results The incidence rate of bradyarrhythmias in the left anterior descending coronary artery was signifi‐cantly lower than that in the right coronary artery and left circumflex artery ,while tachyarrhythmias in the left anterior descending coronary artery was higher than that in right coronary artery and left circumflex artery ,the differences were statistically significant (P<0 .05) .The opening time window and CK‐MB peak reaching time in the RA group were earlier than those in the NRA group , the fall amplitude of ST segment ,highest TnI and highest CK‐MB level in the RA group were higher tha those in the NRA group , the differences were statistically significant (P< 0 .05);among 48 cases of tachyarrhythmias ,tachyarrhythmia in 17 cases disap‐peared after intravenous drip or injection of lidocaine and which in 31 cases spontaneously disappeared without treatment ;among 23 cases of bradyarrhythmia ,bradyarrhythmia in 16 cases was controlled by intravenous injection of atropine ,which in 3 cases was con‐trolled within 1 week after placing temporary pacemaker and which in 4 cases was spontaneously disappeared without treatment . The incidence rate of main adverse events in the RA group was 2 .8% ,which was lower than 11 .7% in the NRA group ,the left ventricular ejection fraction in the RA group was significantly higher than that in the NRA group ,the end diastolic diameter and end systolic diameter of the left ventricle were significantly lower than those in the NRA group ,and the differences were statistically significant (P<0 .05) .Conclusion The incidence of RA in the patients with STEMI is higher ,which needs to adopt various effec‐tive methods to actively treat .%目的：探讨急性ST段抬高型心肌梗死（STEMI）患者直接经皮冠状动脉介入术（PCI）时再灌注心律失常（RA）的临床特征。方法选取2010年1月至2014年12月于该院行急诊PCI的STEMI患者148例，根据PCI中是否发生RA分为RA组（71例）与NRA组（77例）。观察患者RA情况，分析梗死相关动脉与RA的关系，观察抬高的ST段回落情况，对比两组患者肌钙蛋白I（TnI）与肌酸激酶同工酶（CK‐MB）水平，以及心脏彩超结果。结果左前降支缓慢型心律失常的发生率低于右冠状动脉与左回旋支，而左前降支快速型心律失常发生率高于右冠状动脉与左回旋支，差异均有统计学意义（ P＜0．05）。RA组的开通时间窗及CK‐MB达峰时间均早于NRA组，ST段回落幅度、最高TnI及最高CK‐MB水平均高于NRA组，差异均有统计学意义（P＜0．05）；48例快速型心律失常患者中，17例经卡多利因静脉滴注或注射后消失，31例未处理心律失常自行消失；23例缓慢型心律失常患者中，16例经静脉注射阿托品后得以控制，3例经安置临时起搏器后1周内得以控制，4例未处理自行消失。术后，RA组主要不良事件总发生率（2．8％）低于NRA组（11．7％），左室射血分数高于NRA组，左室舒张末期内径与左室收缩末期内径低于NRA组，差异均有统计学意义（P＜0．05）。结论 STEMI患者行PCI时RA的发生率较高，需采取各种有效方法进行积极处理。
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