摘要
目的评价急性ST段抬高型心肌梗死(STEMI)新发不同类型束支传导阻滞(BBB)的临床意义。方法145例住院的STEMI患者,根据入院时有无伴新发BBB分为不伴发BBB组(A组),伴新发左束支传导阻滞(LBBB)组(B组)及伴新发右束支传导阻滞(RBBB)组(C组)。观察比较各组临床资料及住院期间的心血管事件发生率。结果(1)STEMI患者年龄越大越易发生BBB,C组多见于前壁心肌梗死,B组多为更大范围的梗死。(2)B、C组患者住院期间心血管事件发生率为21.6%(8/37),与A组住院期间心血管事件发生率8.3%(9/108)比较,差异有统计学意义(P<0.05);C组发生率为25.0%(5/20),B组为17.6%(3/17),2组比较差异无统计学意义(P>0.05),而分别与A组比较,差异均有统计学意义(P<0.05)。(3)B、C组患者QRS波宽度与住院期间的心血管事件发生有关。(4)在随访期间各组STEMI患者心血管事件发生率差异无统计学意义(P>0.05)。结论STEMI伴发BBB患者住院期间临床心血管事件发生率较高,而伴新发RBBB患者可能比伴新发LBBB院内预后更差。
Objective To evaluate the prognosis of different types of bundle branch block （BBB） during the early acute phase of ST-elevation myocardial infraction （STEMI）. Methods 145 hospitalized STEMI patients were enrolled, and divided into STEMI without BBB （Group A）, STEMI with left BBB （Group B）, STEMI with right BBB （Group C）. The clinical materials and the ratio of major cardiovascular events were analyzed and compared. Results （ 1 ） The incidence of STEMI with BBB had relationship with age, the anterior myocardial infarction was common in group B, and in group C, the larger scale myocardial infarction was common. （2） Incidence rate of major cardiovascular events was 21.6% （8/37） in group B and C, and it showed significant difference with group A 8.3% （9/108）, P 〈 0.05. And there was no remarkable difference between group B and C （ 25.0% vs 17.6% , P 〉 0.05 ）. （ 3 ） The QRS duration time in STEMI patients had relationship with hospitalized cardiovascular events. 4 During the course of follow-up, there was no difference of cardiovascular events among groups, P 〉 0.05. Conclusion It demonstrated that STEMI patients with BBB had higher incidence rate of major cardiovascular events than patients without BBB, and prognosis could be worse in patients with RBBB than with LBBB.
出处
《疑难病杂志》
CAS
2009年第9期522-524,共3页
Chinese Journal of Difficult and Complicated Cases
关键词
心肌梗死
ST段抬高型
急性
束支传导阻滞
再灌注治疗
预后
ST
segment elevation myocardial infarction, acute
Bundle branch block
Reperfusion therapy
Prognosis
