不同传导阻滞表现的急性心肌梗死患者心功能的临床研究  

CLINICAL STUDY ON CARDIAC FUNCTION OF DIFFERENT CONDUCTION BLOCK IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

作　　者：潘浩泉[1] 胡金伦[1] 温宇明[1] 孙毅[1] 

机构地区：[1]佛山市第一人民医院,广东佛山528000

出　　处：《现代医院》2015年第3期38-40,共3页Modern Hospitals

基　　金：佛山市科学技术局科研立项(编号:2014AB00304)

摘　　要：目的探讨不同心脏传导阻滞与急性心力衰竭心功能的关系及其临床意义。方法回顾性分析2011年12月~2013年12月间在我院就诊的心力衰竭患者150例,根据传导阻滞情况的不同,分为房室传导阻滞组、束支传导阻滞组与房室合并束支传导阻滞组。所有研究对象均行心力衰竭常规诊断和治疗,比较三组患者血清脑钠素（BNP）水平、左室舒张末内径、肺毛细血管契压、中心静脉压等指标之间的差异变化。结果房室合并束支传导阻滞组中有吸烟史的人数比例更多,其差异有统计学意义（p〈0.05）。房室合并束支传导阻滞组患者的血清BNP水平、左室舒张末内径、肺毛细血管契压和中心静脉压明显高于束支传导阻滞组和房室传导阻滞组,且束支传导阻滞组的血清BNP水平、左室舒张末内径、肺毛细血管契压和中心静脉压高于房室传导阻滞组,其差异有统计学意义（p〈0.05）。结论吸烟史可能是房室合并束支传导阻滞的危险因素,随着传导阻滞严重程度的增加,血清BNP水平、左室舒张末内径、肺毛细血管契压和中心静脉压均随之增加,这表明传导阻滞,尤其是房室合并束支传导阻滞对心脏功能影响较大。Objective To study the relationship and clinical significance of cardiac function between differ- ent cardiac conduction block and acute heart failure. Methods The clinical data of 150 patients with heart failure ad- mitted in our hospital during 2011 December to December 2013 were retrospectively analysed andrandomly divided in- to atrioventricular block group, bundle branch block group and the group of atrioventricular block combined with bun- dle branch block. All patientsunderwent routine diagnosis and treatment of heart failure. The serum brain natriuretic peptide （BNP） level, the variation of difference between left ventricular end diastolic diameter, pulmonary capillary wedge pressure, central venous pressure and other indicators in the three groups were then compared. Results The patients with smoking history in the group of atrioventricular block and bundle branch bloekaeeounted for the largest proportion, as compared with other two groups （p 〈 0.05 ）. The serum level of BNP and left ventricular end diastolic diameter, pulmonary capillary wedge pressure and central venous pressure inthe group of atrioventricular block and bundle branch block was significantly higher than that of bundle branch block group, atrioventricular block group and bundle branch block group, respectively. The serum level of BNP and left ventricular end diastolic diameter, pulmo- nary capillary wedge pressure and central venous pressure were higher than that in the atrioventricular block group （p 〈 0.05 ）. Conclusion Smoking might be the risk factor of atrioventrieular bundle branch block. With increasingly severe conduction block, the serum level of BNP, left ventricular end diastolic diameter, pulmonary capillary wedge pressure and central venous pressure may increase, which indicates that conduction block, especially atrioventricular bundle branch block has greater influence on cardiac function.

关 键 词：传导阻滞 急性心力衰竭 血清脑钠素 左室舒张末内径 肺毛细血管契压 中心静脉压 

分 类 号：R541.76[医药卫生—心血管疾病]