| 钱程 陈蓉 赵丹丹 黄春恺 洪江.急性心肌梗死伴新发束支传导阻滞的临床意义[J].,2015,15(1):58-62 |
| 急性心肌梗死伴新发束支传导阻滞的临床意义 |
| The Clinical Significance of Bundle Branch Blocks in Patients withAcute Myocardial Infarction |
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| DOI： |
| 中文关键词: 急性心肌梗死 束支传导阻滞 左室射血分数 恶性心律失常 住院病死率 |
| 英文关键词: Acute myocardial infarction Bundle branch block Left ventricular ejection fraction Malignant ventricular arrhythmias In-hospital mortality |
| 基金项目:国家重点基础发展计划"973" 项目(2007CB12008) |
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| 中文摘要: |
| 目的：观察急性心肌梗死伴新发左、右束支传导阻滞的临床特点，评价束支阻滞对急性心肌梗死预后的影响。方法：对上海
交通大学附属第一人民医院心内科重症监护室2010 年1 月1 日到12 月31 日收治的197 例急性心肌梗死患者的病历资料进行
回顾性分析，根据束支传导阻滞有无及类型分为左束支传导阻滞组(12 例)，右束支传导阻滞组(19 例)和对照组(无束支传导阻滞
的急性心梗，166 例)。分析和比较三组患者的基线资料，心梗部位、Killip 分级、恶性室性心律失常、左室射血分数LVEF、病变血管
数量、梗死相关冠脉、住院天数及病死率、实验室检查(BNP，心肌损伤标志物峰值)。结果：LBBB 组AMI患者的恶性心律失常发生
率明显高于对照组(P=0.007)，LVEF 明显低于RBBB 组和对照组(P 值分别为0.020、0.045)，梗死相关动脉以LAD多见。结论：急
性心梗伴束支传导阻滞往往提示病情严重，预后不良，急性心梗合并左束支阻滞较合并右束支阻滞病情更严重。 |
| 英文摘要: |
| Objective:To evaluate the clinical significance of bundle branch blocks (BBB) in patients with acute myocardial infarction
(AMI).Methods:A total of consecutive 197 hospitalized patients with acute myocardial infarction admitted from January 1st,
2010 to December 31st, 2010 were analyzed retrospectively. Patients were divided into three groups. LBBB group: 12 patients with
LBBB and AMI. RBBB group: 19 patients with RBBB and AMI. Control group: remained 166 patients with AMI but not BBBs. The
general characteristics, infarction site, Killip classification, malignant ventricular arrhythmias, left ventricular ejection fraction, infarct-related
coronary artery, in-hospital mortality and the laboratory tests(BNP and the peak of Cardiac markers) were analyzed and compared
among three groups.Results:The incidence rate of malignant ventricular arrhythmias of AMI patients in LBBB group was much higher
than that of the control group (P=0.007), and the LVEF was much lower (P=0.020, 0.045). LAD as IRA was more common in LBBB
group when compared with the control group.Conclusion:Bundle branch blocks in acute myocardial infarction are associated with critical
conditions, and AMI com- bined with LBBB may be more serious than RBBB. |
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