急性下壁心肌梗塞伴房室传导阻滞发生与冠状动脉病变的关系

Relationship Between Atrioventricular Block and Coronary Artery Lesion in Inferior Acute Myocardial Infarction

目的 :研究急性下壁心肌梗塞伴房室传导阻滞 (AVB)发生与冠状动脉病变之间的关系。 方法 :40例急性下壁心肌梗塞患者分为房室传导阻滞组 (AVB组 ,n=16 )和无房室传导阻滞组 (NAVB组 ,n=2 4) ,分析两组间肌酸激酶峰值、冠状动脉病变支数、多支冠状动脉严重病变及优势型冠状动脉狭窄程度对 AVB发生的影响。 结果 :AVB发生与优势型冠状动脉狭窄严重程度有关 ,狭窄程度越高 ,则 AVB发生率越高 ,L ogistic多元回归分析显示优势型冠状动脉狭窄程度是唯一有意义的危险因素 (P=0 .0 0 2 9,OR=8.86 0 1)。 结论 :优势型冠状动脉的严重阻塞是 AVB发生的一个独立因素。

Objective:To investigate the relationship between coronary artery lesion and atrioventricular block (AVB)in patients with inferior acute myocardial infarction(IAMI). Methods:Forty patients with IAMI were divided into AVB( n=16 )and NAVB( n=24 )groups.The number of branches of coronary artary involved,peak value of creatine kinase(CK),significant multivessel stenosis,and dominant coronary vessel stenosis between the two groups were compared. Results:The occurrence of AVB was related to the severity of lesion of the dominant coronary artery,the more severe the dominant coronary artery lesion was,the higher rate of AVB occurred.Logistic regression analysis showed that dominant coronary stenosis was the only significant risk factor to predict AVB( p=0 0029 ,OR=8 8601). Conclusion:Severe dominant coronary artery stenosis is the only index to predict AVB in IAMI.