急性右室心肌梗塞与伴发急性下壁心肌梗塞的临床对比分析  

The contrasting analysis between ARVI and ARVI with IWMI

作　　者：孙莉萍[1] 王红阳[2] 隋铁泉[1] 

机构地区：[1]天津市第五中心医院,天津300450 [2]华北煤炭医学院附属医院,063000

出　　处：《海南医学》2007年第11期5-6,共2页Hainan Medical Journal

摘　　要：目的对比分析急性单纯右室心肌梗死(ARVI)与急性右室心肌梗死伴发急性下壁心肌梗死(IWMI)患者的临床特点。方法由455例急性心肌梗死患者中选出急性单纯右室心肌梗死21例和急性右室心肌梗死伴发下壁心肌梗死68例。比较两组患者的临床表现、并发症、危险因素、冠状动脉造影的结果等因素。结果ARVI组右心功能不全发生比例较高,ARVI合并IWMI组血压下降、颈静脉怒张、泵衰竭发生比例较高(P<0.05);与单纯ARVI组比较,ARVI合并IWMI组传导阻滞、致命性心律失常、休克发生比率、死亡率显著增加且差异具有显著性(P<0.05);冠状动脉造影显示,ARVI组主要以右冠状动脉的右室边缘支闭塞为主,ARVI合并IWMI组以右冠状动脉边缘支近侧闭塞为主;两组患者的危险因素比较差异无显著性(P>0.05)。结论急性右室心肌梗死伴发急性下壁心肌梗死患者临床凶险、预后差。Objective To contrast the cIinical characteristic of ARVI and ARVI with IWMI. Methods We analyzed retrospectively the date of 21 patients of ARVI and 68 patients of IWMI from 455 patients of acute myocardial infarction, compared the result of clinical manifestation, compIicating disease, risk factor, coronary artcriongraphy of the two groups. Results The proportion of right heart insufficiency is higher in group of ARVI then the other, while the proportion of hypotcnsion, jugular vein cngorgcmcnt, pump failure is higher in group of ARVI with IWMI than the others（P〈0.05）, Compared with the group of simple ARVI, incidence rate of conduction block, fatal arrhythmia and shock were raised remarkably with significantly different （P〈0.05, Coronary artcriongraphy showed that the main bIocking in simpIc ARVI was marginal branch in right coronary artery, while it was proximate marginal branch in right coronary artery in ARVI with IWMI risk factor in each group were without significantIy diffcrcnt（P〉0.05）. Concluslons The acute myocardial infarction in right vcntricIc has a poor prognosis.

关 键 词：急性右室心肌梗死 急性下壁心肌梗死 对比分析 

分 类 号：R542.22[医药卫生—心血管疾病]