急性心肌梗死早期合并右束支传导阻滞对患者预后影响

目的:探讨急性心肌梗死(AMI)新发右束支传导阻滞(RBBB)的临床意义及预后。方法:2005年1月到2007年5月住院的AMI患者130例,根据入院时有无合并新发RBBB分为AMI不伴发RBBB组及伴新发右束支传导阻滞(RBBB)组。观察两组的临床情况与心血管事件,并随访平均20.8±7.37月,观察各组患者随访期间的预后。结果:AMI伴新发RBBB多见于前壁心肌梗死。AMI而伴新发RBBB组住院期间心血管事件发生率21.88%,不伴新发RBBB组住院期间心血管事件发生率9.18%。在AMI新发BBB患者中QRS波宽度<160ms住院期间心血管事件发生率17.86%,QRS波宽度≥160ms住院期间心血管事件发生率55.56%,两组相比有统计学意义。两组间随访期间的临床心血管事件无统计学意义。结论:在住院期间,AMI伴新发RBBB心血管事件发生率明显高于不伴发RBBB,QRS的宽度又会增加其临床心血管事件。因此,AMI伴新发RBBB的患者可从早期再灌注治疗中获益最大。

Prognostic significance of right bundle branch block during the early Phase Of acute myocardial infarction patients

Objective :To evaluate the clinical significance and prognosis of right bundle branch block(RBBB) during the early phase of acute myocardial infraction(AMI) patients.Methods :The 145 hospitalized AMI patients were enrolled.According to with or without new RBBB all there patients were divided into two groups: AMI without RBBB group and AMI with new RBBB group.The clinical course,major cardiovascular events and death in all groups were analyzed.After average 20.8±7.37 months follow-up,major cardiovascular events and death in all groups were analyzed too.Results: Incidence rate of major cardiovascular events and death of AMI with RBBB patients(21.88%) has significant difference with AMI without BBB patients(9.18%,P<0.05) duration of hospital.Patients with QRS duration 160 ms had higher Incidence rate of major cardiovascular events and death than those with QRS duration <160 ms(55.56% versus 17.86%,P<0.05).In the follow-up period,there was no significant difference incidence rate of major cardiovascular events and death among groups of AMI patients.Conclusion: AMI patients with new RBBB have increased incidence rate of major cardiovascular events and death than patients without new RBBB duration of hospital.Increasing QRS duration is associated with increasing incidence rate of major cardiovascular events and death duration of hospital.All of those indicating that AMI patients who have new RBBB may benefit from more aggressive reperfusion therapy.