右室心肌梗死对急性下后壁心肌梗死预后的影响

Influence of right ventricular infarction on the prognosis of acute inferior behind myocardial infarction

目的探讨右室心肌梗死对急性下后壁心肌梗死预后的影响。方法对比分析自2002年2月-2006年2月在我院住院治疗的42例合并右室心肌梗死的急性下后壁心肌梗死（IWMI合并RVMI组）的患者与40例单纯下后壁心肌梗死（IWMI组）的患者，在住院期间及出院后病死率及心衰、心律失常等并发症发生率的差异。结果经研究得出急性下后壁心肌梗死合并右室心肌梗死时与单纯急性下后壁心肌梗死对比，患者院内病死率（29％对5％，P〈0．01）及心律失常、心衰、心源性休克等主要并发症的发生率（67％对29％，P〈0．01）均明显高于单纯急性下后壁心肌梗死的患者。经1-4年随访，合并右室心肌梗死的患者出院后病死率（35％对16％，P〈0．05）及心衰、心律失常等并发症的发生率（75％对36％，P〈0．05）均明显增高。结论合并右室心肌梗死的急性下后壁心肌梗死患者预后不良。

Objective To studay the influence of right ventricular infarction （RVI） on the prognosis of acute inferior behind myocardial infarction. Methods The mortality and hear failure,arrhythmia occurrence of the patients in-hospital and out-hospital were compared between the 42 patients with acute inferior behind myocardial infarction and RVI and the 40 patients with acute inferior behind myocardial infarction from february 2002 to february 2006. Results In-hospital the mortality （29%） and the heat failure, cardiac shock, arrhythmia occurrence （67%） in the patients with acute inferior behind myocardial infarction and RVI were markedly higher than in the patients with acute inferior behind myocardial infarction （5%,29%）,the two groups were significant deviation （P〈0.01）. Through fellowed up 1-4 years the mortality （35%） and the heat failure,cardiac shock, arrhythmia occurrence（75%）in the patients with RVI were markedly higher than in the patients without RVI（16%,36%, P〈0.05）. Conclusion The prognosis of the patients with acute inferior bihind myocardial infarction and RVI is bad.