急性下壁心肌梗塞并左前分支传导阻滞的临床意义

Clinical Singnificance of Left Anterior Hemiblook Occuring in Inferior Wall Acute Myocardial Infarction

将 70例首次发生下壁心肌梗塞 (下壁 AMI)的患者分为两组。 A组为 14例合并左前分支传导阻滞 ( LAH)者 ,B组为 56例单纯下壁 AMI者。比较两组患者住院期间心脏事件 (梗塞后心绞痛、再梗塞、充血性心力衰竭、心源性休克及死亡 )的发生率及出院前左室射血分数 ( LVEF)、室性心律失常( VA)发生率。结果显示 ,A组住院期间心脏事件发生率 ( 64.3% )明显高于 B组 ( 19.6% ) ,P<0 .0 1;出院前 LVEF[( 4 5.7± 12 .8) % ]明显低于 B组 [( 57.2± 9.6) % ],P<0 .0 1;VA发生率 ( 64.3% )明显高于B组 ( 2 5.0 % ) ,P<0 .0 5。提示下壁 AMI发生 L AH者近期预后不良 。

patients with first inferior wall acute myocardial infarction(AMI)were divided into two groups according to ECG.Group A(14 patients) occured left anterior hemiblock(LAH),group B(56 patients)without LAHCardiac events(congestive heart failure,reinfarction or postinfarction angina,cardiac shock and cardiac death)during hospitalization,the left ventricuar ejection fraction(LVEF)and the incidence of ventricular arrhythmia(VA)before discharge were comparedIn group A,the incidience of cardiac events during hospitalization was highter,the LVEF before discharge was lower and the incidence of VA was higher than those in group B(P<001,p<001,P<005)The result suggest that the patients with LAHin inferior wall AMI have a bad prognosis and the LAH occuriny in inferior wall AMI is a sign of significant stenosis in the left anterior descending coronary artery and multivessel coronary artery disease