急性下壁心肌梗死合并高度房室传导阻滞患者临床特征及预后

目的观察急性下壁心肌梗死合并高度房室传导阻滞(AVB)患者的临床特点及预后。方法选取急性下壁心肌梗死合并高度AVB患者36例和不合并高度AVB患者116例,比较两组间一般临床特点(年龄、性别、高血压、高脂血症、糖尿病、吸烟)、CK峰值以及主要不良事件(包括右室心肌梗死、心力衰竭、低血压休克、恶性心律失常发生率,胸前导联ST段压低出现率及住院死亡率)的差异性。结果相比较于不合并AVB组,急性下壁心肌梗死合并高度AVB组患者年龄、CK峰值显著增加(P0.05),胸前导联ST段压低、右室梗死、心力衰竭及低血压休克发生率明显升高,住院死亡率亦明显增加,组间差异均有统计学意义(P0.05)。结论高度AVB是急性下壁心肌梗死的常见并发症,能够显著增加近期住院死亡率及不良事件的发生。

Clinical features and prognosis of advanced atrioventricular conduction block complicated with acute inferior myocardial infarction

Objective To observe the clinical features and prognosis of acute inferior myocardial infarction complicated with advanced atrioventricular block （AVB）.Methods 36 cases of acute inferior myocardial infarction complicated with advanced AVB and 1 16 cases without advanced AVB were Collected.clinical characteristics （age, sex,hypertension,hyperlipidemia,diabetes and smoking）and major adverse events （right ventricular myocardial infarction,heart failure,hypotension and shock,the incidence of malignant arrhythmia and precordial ST segment depression occurrence rate,in-hospital mortality）,as well as the CK peak,were analyzed between two groups.Results Compared with acute inferior myocardial infarction patients without advanced AVB,patients with advanced AVB were older,and had a higher level of serum CK peak（P〈0.05）.Furthermore,a significantly higher incidence of major adverse events （right ventricular myocardial infarction,heart failure,hypotension and shock,malignant arrhythmia,precordial ST segment depression,in-hospital mortality）were observed （P〈0.05）in patients with advanced AVB.Conclusion Advanced AVB is a common complication in patients with acute inferior myocardial infarction,which significantly increases in-hospital mortality and incidence of major adverse events.