目的探讨急性心肌梗死(AMI)在尿激酶静脉溶栓治疗中再灌注心律失常的特点。方法分析175例采用尿激酶静脉溶栓治疗AMI患者的临床资料,观察冠脉再通后心律失常的发生情况。结果101例(57.7%)判定为临床再通,79例(78.2%)发生再灌注心律失常,其中35例(34.65%)发生加速性室性自主心律(AIVR),19例发生一过性窦性心动过缓,且仅发生于下/后壁心肌梗死患者。结论再灌注心律失常以加速性室性自主心律最常见,且特异性高,可作为判断再灌注较为可靠的指标。一过性窦性心动过缓可作为下壁心肌梗死再灌注的可靠指标。大多数再灌注心律失常不必常规使用抗心律失常药物。 Objective To investigate the characteristics of acute myocardial infarction (AMI) reperfusion arrhythmia in urokinase intravenous thrombolytic therapy. Methods 175 patients with AMI treated with intravenous thrombolytic therapy of urokinase were enrolled in this study. The incidence of arrhythmia after coronary reperfusion was observed. Results A total of 101 cases (57.7%) were confirmed as recanalization and 79 cases (78.2%) had reperfusion arrhythmia. Among them, 35 cases (34.65%) had anaplastic ventricular arrhythmias (AIVR) and 19 cases had a transient sinus Bradycardia and occurs only in patients with inferior / posterior wall myocardial infarction. Conclusion The reperfusion arrhythmia to accelerate the most common ventricular arrhythmia, and high specificity, can be used as a more reliable indicator of reperfusion. A transient sinus bradycardia can be used as a reliable indicator of myocardial infarction reperfusion. Most reperfusion arrhythmias do not require routine use of anti-arrhythmic drugs.