急性心肌梗死合并持续性完全性右束支传导阻滞32例

目的探讨急性心肌梗死（AMI）合并完全性右柬支传导阻滞（CRBBB）的临床特点及对预后的影响。方法对近5年收住我院的AMI病例进行回顾性分析，将临床资料分为两组，其中观察组32例，为新出现持续性完全性右束支传导阻滞的急性心肌梗死患者；对照组270例，为同期收住院的无右束支传导阻滞的急性心肌梗死患者。两组患者进行一般情况、心肌梗死部位、心肌酶水平、心功能情况、并发症、临床经过及住院病死率比较。结果两组一般情况及并发症比较差异无统计学意义（P〉0．05），两组临床经过及住院病死率比较，观察组中的休克、恶性心律失常、前壁心肌梗死，心功能不全、房室传导阻滞的发生率及病死率均较对照组显著增高（P〈0．05）。结论急性心肌梗死出现持续性完全性右束支传导阻滞预示病情严重、并发症发生多，预后差。

Right bundle branch block in 32 patients with acute myocardial infarction

Objective To evaluate the clinical characteristics and prognosis significance of right bundle branch （RBBB） in patients with acute myocardial infarction （AMI）. Methods The clinical data of patients with acute myocardial infarction in our hospital in recent five years were retrospectively analyzed. Patients were divided into two groups, observation group： 32 patients with AMI and newly appeared persistent RBBB, and control group ： 270 patients with AMI but without bundle branch block. The general state and complicating disease, the clinical course and inhospital mortality of the two groups were analyzed. Results The general state and complicating disease of the two groups showed no significant difference （ P 〉 0.05 ） , but in observation group the rates of shock, malignant arrhythmia, anterior myocardial infarction, cardiac insufficiency, auriculo - ventricular block, and inhospital mortality were much higher than those in control group （ P 〈 0. 05 ）. Conclusions Newly appeared persistent CRBBB accompanied with AMI could indicate a dangerous clinical course and bad prognosis.