急性心肌梗死伴发房室传导阻滞的临床分析  

Clinical Analysis of AV Block in Different Stages of Acute Myocardial Infarction.

作　　者：滕玲[1] 

机构地区：[1]台州医院,浙江台州318050

出　　处：《心脑血管病防治》2004年第4期14-16,共3页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的　探讨急性心肌梗死病人不同时期发生房室传导阻滞的临床特点及预后。方法　采用非创伤性心电监测及心电图检查 ,对 3 8例AMI发生AVB病例 ,根据心电图分期 ,分为超急性期、演变期和恢复期三组 ,对AVB发生的时间、持续时间、程度 ,临床特点及预后进行分析。结果　 87 5 %房室传导阻滞在急性心梗起病后 1 2小时内出现。超急性期发生AVB较演变期、恢复期发生AVB的时间早 ,持续时间短、程度重 ,严重并发症发生率高。阿托品类药或异丙肾上腺素治疗的病人多数有不同程度的改善 ,预后良好。结论　急性心肌梗死病人超急性期发生AVB较演变期和恢复期发生AVB的病情重 ,并发症多而严重 ,用阿托品类药或异丙肾上腺素治疗的病人 ,多数有不同程度的改善。大多数AMI合并AVB不用起搏器治疗。Objective To observe the clinical characteristics, treatment and prognosis of AV block in patients with acute myocardial infarction (AMl) of different stages. Methods According to ECG,38 AMI patients with AV block were divided into three groups:super acute stage,developing stage and recover stage.AV block occurring and lasting time,degree, clinical characteristics and prognosis of AV block were analysed.Results The majority(87.5%)of AV block appeared within 12 hours after the onset of acute myocardial infarction. Compared with developing and recover stages,AV block in super acute stage occurred earlier, more severe, the lasting time was shorter and the rate of complication was higher. To treat with atropine and isopropylarterenol,the majority of AV block was improved in different degree and the prognosis was well. Conclusions AMI patients with AV block in super acute stage are more severe and have more complications than those in developing stage and recover stage.The majority of AV block is able to improve with atropine and isopropylarterenol treatment and doesn't need to treat with artificial cardiac pacing.

关 键 词：急性心梗 房室传导阻滞 时期 

分 类 号：R542.22[医药卫生—心血管疾病]