摘要
目的探讨急性心肌梗死(AMI)合并束支传导阻滞患者的临床特点及预后。方法纳入近10年于清华大学第一附属医院行冠状动脉(冠脉)造影检查的522例AMI患者,分为AMI合并左束支传导阻滞组(n=22)、AMI合并右束支传导阻滞组(n=28)及不合并束支传导阻滞组(n=472)。分别收集三组患者的一般资料、生化及影像学检查并比较。结果合并左束支传导阻滞组在糖尿病及陈旧心肌梗死比例、炎性指标、肌酐(CRE)、尿素(BUN)、CK-MB峰值、左房前后径(LAAP)、左室舒张末期容积(LVEDV)、右房内径(RAD)、恶性心律失常发生率、冠脉病变数量方面均高于不合并束支传导阻滞组,射血分数(EF)低于不合并束支传导阻滞组(P<0.05);合并右束支传导阻滞组在年龄、糖尿病比例、陈旧心肌梗死比例、CRE、BUN、CK-MB峰值、LAAP、LVEDV、恶性心律失常发生率方面均高于不合并束支传导阻滞组,EF低于不合并束支传导阻滞组(P<0.05);合并左束支传导阻滞组在炎性指标、CK-MB峰值、LAAP、LVEDV、RAD方面均高于合并右束支传导阻滞组,在年龄和射血分数方面低于合并右束支传导阻滞组(P<0.05);结论合并束支传导阻滞患者并发症多、病情重、预后不良。
Objectives To explore the clinical characteristics and prognosis of patients with acute myocardial infarction(AMI)combined with bundle branch block.Methods 522 AMI patients who underwent coronary angiography in the First Affiliated Hospital of Tsinghua University in the past 10 years were enrolled.They were divided into AMI combined with left bundle branch block group(22 cases),AMI combined with right bundle branch block group(28 Example),and AMI without bundle branch block group(472 cases).The general data,biochemical and imaging examination results of the three groups of patients were collected and compared.Results In the group with left bundle branch block,the proportion of diabetes and old myocardial infarction,inflammatory index,creatinine level(CRE),urea level(BUN),CK-MB peak,left atrium anteroposterior diameter(LAAP),left ventricular end-diastolic volume(LVEDV),right atrial diameter(RAD),incidence of malignant arrhythmia,and number of coronary artery lesions were higher than those in the group without bundle branch block,and the ejection fraction(EF)was lower than in the group without bundle branch block(P<0.05).The group with right bundle branch block is higher than the group without bundle branch block in terms of age,proportion of diabetes,proportion of old myocardial infarction,CRE,BUN,peak CK-MB,LAAP,LVEDV,and incidence of malignant arrhythmia.EF was lower than the group without bundle branch block(P<0.05).The inflammatory index,CK-MB peak value,LAAP,LVEDV and RAD in the combined left bundle branch block group were higher than those in the combined right bundle branch block group,and lower in age and ejection fraction than the combined right bundle branch Block group(P<0.05).Conclusion Patients with bundle branch block have many complications,serious illness and poor prognosis.
作者
张晗
商丽华
孙蔚雯
徐新华
Zhang Han;Shang Lihua;Sun Yuwen;Xu Xinhua(Department of Cardiology,The First Affiliated of Tsinghua University,Beijing 100016,China;不详)
出处
《中国循证心血管医学杂志》
2021年第3期346-348,353,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
