急性下壁心肌梗死_

高度房室传导阻滞在急性下壁心肌梗死预后中的意义

http://www.100md.com 《疑难病杂志》 2006年第1期

急性下壁心肌梗死,,急性下壁心肌梗死；高度房室传导阻滞；预后,1对象与方法,2结果,3讨论,参考文献

     【关键词】急性下壁心肌梗死；高度房室传导阻滞；预后

    【摘要】目的探讨高度房室传导阻滞(AVB)在急性下壁心肌梗死患者预后中的意义。方法比较急性下壁心肌梗死伴有高度AVB组(39例)和不伴有高度AVB组(137例)患者的一般情况及其住院期间和1年随访中的病死率、不良事件(低血压休克、心力衰竭和恶性心律失常)的发生情况。结果 2组患者相比，伴有高度AVB组患者年龄大，女性比例多，糖尿病患病率更高，CK峰值大，左心室射血分数低，更多累及右心室，2组差异均有显著意义(P<0.05)。2组患者住院期间病死率(12.8% 比3.6%，P=0.029)、心力衰竭(33.3% 比18.2%，P=0.043)和低血压休克(20.5%比8.8%,P=0.041)发生率差异有显著意义，但存活患者长期随访中的病死率(5.9%比3.8%，P=0.588)和心力衰竭发生率(35.3%比19.7%,P=0.054)差异无显著意义。结论高度AVB是急性下壁心肌梗死患者的常见并发症，其住院期间病死率和不良事件发生率显著增高，但对远期预后无显著影响。

    Prognostic significance of advanced atrioventricular block in acute inferior myocardial infarction

    YANG Zhenkun,GUAN Jingshu,SHEN Weifeng,et al.Department of Cardiology, Ruijin Hospital, Shanghai jiaotong University,Shanghai 200025,China

    【Abstract】 Objective To assess the incidence and prognostic significance of advanced atrioventricular block (AVB) complicating inferior acute myocardial infarction (AMI).Methods Advanced AVB was defined as the presence of seconddegree Mobitz type II AVB or complete AVB. The diagnosis was made by continuous ECG monitoring during the first week of admission. Results Of the 176 patients with inferior AMI,39(22%) developed advanced AVB during hospitalization. The patients with advanced AVB were older,included more female, and had a higher rate of diabetes mellitus. The patients in whom advanced AVB development were more likely associated with right ventricular involvement (35.9% vs 20.4% ......

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