冠心病伴束支传导阻滞患者冠状动脉病变特点研究

目的 :探讨冠心病伴束支传导阻滞患者冠状动脉血管病变特点。方法 :回顾性分析冠心病伴束支传导阻滞患者 (束支阻滞组 ,39例 )及无束支阻滞的冠心病患者 (对照组 ,35 1例 )心电图束支阻滞有无与冠状动脉病变的对应关系。结果 :与对照组比较 ,束支阻滞组左主干、左回旋支 (LCX)及三支血管 [左前降支 (LAD)、LCX、右冠状动脉 (RCA)同时存在病变 ]发生病变比率增加 (P <0 .0 1,P <0 .0 5 ,P <0 .0 5 )。右束支传导阻滞(RBBB)者LAD及RCA发病率高 ,RBBB并发左前分支阻滞 (LAFB)者三支血管病变发生率增高 ,左束支传导阻滞 (LBBB)者LAD、LCX病变发生率高 ,LAFB者LAD病变发生率高 ,房室传导阻滞伴束支阻滞患者多为三支血管病变。结论 :冠心病伴束支阻滞预示冠状动脉病变广泛而严重 ,LBBB提示冠状动脉血管病变以左冠状动脉为主 ,RBBB提示冠状动脉血管病变多累及RCA及LAD ,如存在 2种以上阻滞 ,特别是并发有左前分支或房室阻滞时 ,多提示存在三支血管病变及左主干病变

Characteristics of coronary artery lesions in coronary heart disease patients with bundle branch block

Objective: To explore the characteristics of coronary artery lesions according to coronary angiogram (CAG) in coronary heart disease (CHD) patients with bundle branch block (BBB). Method: We selected 39 CHD patients with BBB from 390 patients of CHD diagnosed by CAG in Liaoning cardiointervention center in 1999. The relationship between BBB and coronary artery lesions was analyzed. Three hundred and sixty four patients of CHD without BBB were enrolled as control group. Result: The morbidity of left main branch (LM), left circumflex branch (LCX) and three vessel lesions in trail group was higher than that in control group (P< 0.01 , P< 0.05 , P< 0.05 ). Especially, patients got more lesions of left anterior descending branch (LAD) and right coronary artery (RCA) in the case of RBBB and more lesions of three vessels in patients with both RBBB and left anterior fascicular block (LAFB). Whereas in patients with LBBB, the occurence of LAD and LCX lesions increased. Patients with LAFB had a higher incidence of LAD lesions. Three vessels lesions were usually found in the case of atriventricular block (AVB) complicated with BBB. Conclusion: The occurrence of left coronary artery lesions is high in LBBB patients. RBBB predicts not only RCA lesions but also LAD lesions. Three vessel lesions often accompany with LM lesions and occur more likely in more than two kinds of BBB patients, especially with left anterior fascicular block or AVB.