急性心肌梗死伴发右束支传导阻滞的临床特征分析  

Clinical analysis of right bundle branch block in patients with acute myocardial infarction

作　　者：安宁 

机构地区：[1]陕西省榆林市第四医院心内科,陕西榆林719000

出　　处：《实用临床医药杂志》2012年第19期32-34,共3页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11220181)

摘　　要：目的探讨急性心肌梗死(AMI)伴发新出现的完全性右束支传导阻滞(CRBBB)的临床意义。方法选取AMI患者169例,分为2组,AMI伴发新出现的CRBBB患者36例作为CRBBB组,单纯AMI患者133例作为非CRBBB组,对2组患者的心功能Killip分级、心律失常发生率及住院病死率等临床资料进行对比性分析。结果 CRBBB组梗死部位多为前壁或广泛前壁,梗死动脉多为前降支近端;CRBBB组CK和CK-MB峰值、心功能Killip平均分级和分级≥Ⅲ级发生率、恶性室性心律失常发生率、缓慢型心律失常发生率以及院内病死率均显著高于非CRBBB组,但其左心室射血分数(LVEF)显著低于非CRBBB组,组间比较差异有统计学意义(P<0.05)。结论 AMI伴发新出现的持续性CRBBB,提示临床病情凶险,预后不良,可作为AMI患者病情恶化的一个很有价值的预测指标。Objective To evaluate the clinical significance of acute myocardial infarction （AMI） combined with complete right bundle branch block （CRBBB）. Methods A total of 169 AMI patients were divided into AMI combined with CRBBB group （CRBBB group, n = 36） and AMI alone group （non-CRBBB group, n = 133）. Killip grading of heart function, incidence rate of severe arrhythmogenesis and fatality rate were compared. Results The infarction site of CRBBB group was at anterior or extensive anterior wall, and infarction artery was mainly proximal anterior descending artery. The peak value of CK and CK-MB, average grade of heart function and the rate of Killip≥grade Ⅲ, the incidence of malignant ventricular arrhythmia, slow arrhythmia incidence and hospital mortality of CRBBB group were significantly higher than those of non-CRBBB group. while the left ventricular ejection fraction （LVEF） of CRBBB group was significantly lower than that of non-CRBBB group （P 〈 0.05）. Conclusion Acute myocardial infarction combined with CRBBB suggests the severity of disease and the poor prognosis, which could be a valuable prediction of aggravation in AMI patients.

关 键 词：急性心肌梗死 完全性右束支传导阻滞 预后 

分 类 号：R542.2[医药卫生—心血管疾病]