急性心肌梗死不同时期发生的房室传导阻滞

Atrio-ventricular Block in Different Stages of Acute Myocardial Infarction

目的：探讨急性心肌梗死病人不同时期发生的房室传导阻滞（ＡＶＢ）的临床特点、治疗及预后。方法：采用非创伤性心电监测法监测４６６例Ｑ波型心肌梗死病人ＡＶＢ的发生率和药物治疗反应及演变。其中６５例病人发生ＡＶＢ，按发生的不同时期分为两组：①早发组，１５例为发病８小时内出现ＡＶＢ；②晚发组，５０例为发病８小时后出现ＡＶＢ。结果：４６６例心肌梗死中，发生房室传导阻滞６５例（１４％）。晚发组比早发组死亡率高（Ｐ＜０．０５）；晚发组泵衰竭多于早发组（Ｐ＜０．０５）；用阿托品治疗后早发组比晚发组有效。结论：急性心肌梗死病人ＡＶＢ早发组比ＡＶＢ晚发组病情较轻，部分病人药物治疗有效，预后较好。

? Objective:To study the clinical characteristics,treatment and prognosis of atrioventricular block(AVB) in patients with acute myocardial infarction(AMI) of different stages. Methods:Four hundred and sixtysix cases of AMI were monitored by ECG for the incidence,therapeutic effect and development of AVB.According to the different stages of AMI,65 patients with AVB were divided into two groups:Group 1(n=15):AVB appeared within 8 hrs(early stage)after the onset of AMI.Group 2 (n=50):AVB appeared more than 8 hrs(late stage)after the onset of AMI. Results:Sixty five out of 466 AMI patients(14%) had AVB.The mortality was higher in group 2 than in group 1(p<0.05).The incidence of pump failure was also higher in group 2(p<0.05).Atropine was more effective in group 1 than in group 2. Conclusion:The results suggest that the AMI patients with early onset of AVB are less severe,part of them have a better therapeutic result and prognosis.