急性前壁心肌梗死合并RBBB的临床特点  

Clinical features of acute anterior myocardial infarction combined with right bundle branch block

作　　者：陈多学[1] 潘路华 梁潇 Chen duoxue;Pan luhua;Liang xiao(Bozhou People's Hospital,236800,China)

机构地区：[1]安徽省亳州市人民医院,236800

出　　处：《临床心电学杂志》2021年第5期359-363,共5页Journal of Clinical Electrocardiology

摘　　要：目的探讨急性前壁心肌梗死合并右束支阻滞(RBBB)的临床特点。方法回顾性对比分析2016年5月至2021年6月在我院住院治疗的急性前壁心肌梗死合并与不合并右束支阻滞的患者的临床经过、心电图和预后。结果观察组为急性前壁心肌梗死合并右束支阻滞患者,共有81例,其中48例为急性ST段抬高型心肌梗死,33例为急性非ST段抬高型心肌梗死,前降支近段急性闭塞59例,对照组为急性前壁心肌梗死不合并右束支阻滞者,共有526例,其中365例为急性ST段抬高型心肌梗死,161例为急性非ST段抬高型心肌梗死,住院期间死亡率和主要心脏不良事件发生率观察组均要高于对照组。结论急性前壁心肌梗死合并右束支阻滞往往提示前降支近段急性闭塞,心肌坏死面积大,血流动力学往往不稳定,住院期间心脏不良事件发生率要高于急性前壁心肌梗死不合并右束支阻滞者。前降支开口齐头闭塞也不一定导致新发右束支阻滞。Objective To explore the clinical characteristics of the patients with acute anterior myocardial infarction with right bundle brunch block. Methods Retrospectively comparative analysis the clinical characteristics,ECG and prognosis of the patients with acute anterior myocardial infarction with and without right bundle brunch block in our hospital from May 2016 to June 2021. Results The observe group were the patients with acute anterior myocardial infarction with right bundle brunch block, including 48 patients with ST segment elevation acute myocardial infarction and 33 patients with non-ST segment elevation acute myocardial infarction. There were 59 cases of acute complete occlusion in the proximal descending branch. The control group were the patients with acute anterior myocardial infarction without right bundle brunch block, including 365 patients with ST segment elevation acute myocardial infarction and 161 patients with non-ST segment elevation acute myocardial infarction. The mortality in-hospital and the major adverse cardiac events in the observe group were higher than those in the control group.Conclusions Acute anterior myocardial infarction with right bundle brunch block often indicates the occlusion in the proximal anterior descending branch, the large area of myocardial necrosis, the unstable hemodynamics, and the mortality and major adverse cardiac events during hospitalization are higher than those in the control group. The occlusion of the ostium anterior descending artery does not necessarily lead to right bundle branch block.

关 键 词：前降支 急性心肌梗死 右束支阻滞 

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