心脏传导阻滞与心肌梗死部位的关系和对临床预后的影响

Relationship between cardiac conduction block and the site of myocardial infarction and its significance in clinical prognosis

目的探讨心脏传导阻滞与心肌梗死部位的关系及对临床预后的影响。方法对167例急性心肌梗死病例进行回顾分析,比较不同部位急性心肌梗死中不同类型心脏传导阻滞的发生情况,并比较合并心脏传导阻滞的患者与无传导阻滞患者住院期间心力衰竭、心源性休克、恶性室性心律失常发生率及死亡率的不同。结果①急性心肌梗死中心脏传导阻滞的发生率为30.5%。②合并房室传导阻滞的病例中,下壁组明显高于前壁组;而前壁组束支传导阻滞的发生率显著高于下壁组。③合并心脏传导阻滞的患者,其住院期间心力衰竭、心源性休克、恶性室性心律失常发生率,及住院期间死亡率均明显高于无传导阻滞组。结论心脏传导阻滞的发生与心肌梗死部位有关,可增加心肌梗死患者的并发症发生率及死亡率,对临床预后有重要影响。

Objective To investigate the relationship between cardiac conduction block and the site of myocardial infarction and its significance in clinical prognosis. Methods The data of 167 patients with acute myocardial infarction（AMI） were retrospectively analyzed. The incidences of different types of cardiac conduction block were compared in the patients with different locations of myocardial infarction. The incidences of heart failure, cardiogenic shock, malignant ventricular arrhythmia, and in-hospital mortality were compared between patients with AMI complicating cardiac conduction block and patients with AMI. Results ①Incidence of cardiac conduction block was 30.5% in patients with AMI. ②In all patients with atrioventricular block, the patients with inferior wall myocardial infarction was significantly more than those with anterior wall myocardial infarction, and patients with anterior wall myocardial infarction had more bundle branch block than those with inferior wall myocardial infarction. ③The patients with cardiac conduction block had higher incidence of heart failure, cardiogenic shock, malignant ventricular arrhythmia,in-hospital mortality than those without cardiac conduction block. Conclusion Types of cardiac conduction block are related to location of myocardial infarction. Cardiac conduction block can increase the incidence of complications and mortality in patient with AMI and is an important factor in clinical prognosis of patients with AMI.