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急性心肌梗死伴新发束支传导阻滞的临床意义 被引量:7

The Clinical Significance of Bundle Branch Blocks in Patients with Acute Myocardial Infarction
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摘要 目的:观察急性心肌梗死伴新发左、右束支传导阻滞的临床特点,评价束支阻滞对急性心肌梗死预后的影响。方法:对上海交通大学附属第一人民医院心内科重症监护室2010年1月1日到12月31日收治的197例急性心肌梗死患者的病历资料进行回顾性分析,根据束支传导阻滞有无及类型分为左束支传导阻滞组(12例),右束支传导阻滞组(19例)和对照组(无束支传导阻滞的急性心梗,166例)。分析和比较三组患者的基线资料,心梗部位、Killip分级、恶性室性心律失常、左室射血分数LVEF、病变血管数量、梗死相关冠脉、住院天数及病死率、实验室检查(BNP,心肌损伤标志物峰值)。结果:LBBB组AMI患者的恶性心律失常发生率明显高于对照组(P=0.007),LVEF明显低于RBBB组和对照组(P值分别为0.020、0.045),梗死相关动脉以LAD多见。结论:急性心梗伴束支传导阻滞往往提示病情严重,预后不良,急性心梗合并左束支阻滞较合并右束支阻滞病情更严重。 Objective: To evaluate the clinical significance of bundle branch blocks(BBB) in patients with acute myocardial infarction(AMI). Methods: A total of consecutive 197 hospitalized patients with acute myocardial infarction admitted from January 1st,2010 to December 31 st, 2010 were analyzed retrospectively. Patients were divided into three groups. LBBB group: 12 patients with LBBB and AMI. RBBB group: 19 patients with RBBB and AMI. Control group: remained 166 patients with AMI but not BBBs. The general characteristics, infarction site, Killip classification, malignant ventricular arrhythmias, left ventricular ejection fraction, infarct-related coronary artery, in-hospital mortality and the laboratory tests(BNP and the peak of Cardiac markers) were analyzed and compared among three groups. Results: The incidence rate of malignant ventricular arrhythmias of AMI patients in LBBB group was much higher than that of the control group(P=0.007), and the LVEF was much lower(P=0.020, 0.045). LAD as IRA was more common in LBBB group when compared with the control group. Conclusion: Bundle branch blocks in acute myocardial infarction are associated with critical conditions, and AMI com- bined with LBBB may be more serious than RBBB.
出处 《现代生物医学进展》 CAS 2015年第1期58-62,共5页 Progress in Modern Biomedicine
基金 国家重点基础发展计划"973"项目(2007CB12008)
关键词 急性心肌梗死 束支传导阻滞 左室射血分数 恶性心律失常 住院病死率 Acute myocardial infarction Bundle branch block Left ventricular ejection fraction Malignant ventricular arrhythmias In-hospital mortality
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