AMI伴或不伴RBBB时室早Lown分级与MTWA  

Comparison of Lown grades and MTWA in acute myocardial infarction patients with or without right bundle branch block

作　　者：聂文娟 冯应君[1] 叶培机 黄艳 李雯静 王婷[1] 谭景[1] 聂思佩 Nie wenjuan;Feng yingjun;Ye peiji;Huang yan;Li wenjing;Wang ting;Tan jing;Nie sipei(Yue Bei People's Hospital,Shaoguan,Guangdong,512026,China)

机构地区：[1]广东省韶关市粤北人民医院,512026

出　　处：《临床心电学杂志》2022年第6期426-430,共5页Journal of Clinical Electrocardiology

基　　金：广东省韶关市卫生健康科研项目(项目编号:Y21076)

摘　　要：目的探讨急性心肌梗死伴或不伴右束支阻滞患者的动态心电图室性早搏Lown分级与微伏级T波电交替(Microvolt T wave alternans,MTWA)的差异。方法选取2017-2021年在粤北人民医院住院并行PCI治疗的215例急性心肌梗死患者,依据心电图是否合并右束支阻滞分为右束支组和非右束支组,其中右束支组64例,非右束支组151例。采用1:1倾向性评分匹配法匹配两组的基线资料以均衡组间协变量。匹配后对两组间的动态心电图室早Lown分级和MTWA结果进行比较。结果共53对完成倾向性评分匹配,经匹配两组间基线资料达到基本平衡。匹配后,右束支组室早Lown中、高危分级有28例(43.4%),高于非右束支组,10例(18.9%),差异有统计学意义(P<0.05)。右束支组MTWA的阳性率为26.4%,非右束支组为7.5%,差异有统计学意义(P<0.05)。结论与非右束支组相比,急性心肌梗死伴右束支阻滞患者的Lown中、高危分级及MTWA阳性率更高,发生恶性室性心律失常的风险较高。Objective To investigate the difference of ventricular premature Lown grades and microvolt T wave alternans(MTWA)in acute myocardial infarction(AMI)patients with or without right bundle branch block(RBBB).Methods 215 patients with AMI after PCI in Yue Bei People's Hospital from 2017 to 2021 were selected.According to whether ECG combined with RBBB,it was divided into RBBB group and non-RBBB group.There were 64 cases in the RBBB group and 151 cases in the non-RBBB group.The baseline data of the two groups were matched by 1:1 propensity score matching(PSM)method to balance the covariates between the groups.After matching,the results of Lown grades and MTWA between the two groups were compared.Results A total of 53 pairs completed PSM,and the covariates between the two groups were balanced after matching.After matching,there were 28 cases(43.4%)of medium and high risk Lown grades in the RBBB group,which was higher than 10 cases(18.9%)in the non-RBBB group(P<0.05).The positive rate of MTWA was 26.4%in the RBBB group and 7.5%in the non-RBBB group(P<0.05).Conclusions Lown grades and MTWA positive rates were higher in patients with RBBB than without RBBB.In RBBB patients of AMI had higher risk of ventricular arrhythmia than non-RBBB patients.

关 键 词：急性心肌梗死 右束支阻滞 室性早搏Lown分级 微伏级T波电交替 倾向性评分匹配 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]