右冠状动脉与左回旋支病变致右室梗死32例临床对比分析

The clinical analysis of 32 patients with right ventricular myocardial infarction related with right coronary or left circumflex branch lesion

目的探讨右冠脉与左回旋支病变致右室梗死冠脉病变特点及临床特征。方法筛选我院2007年10月至2013年11月入院的32例右室心肌梗死患者，根据梗死相关动脉分为右冠组（25例）和左回旋支组（7例）。收集其临床资料及冠脉造影结果，进行分析总结。结果右冠组多为近段病变，左回旋支组多为中远段病变。右冠病变致右室梗死，其缓慢性心律失常发生率高于左回旋支病变（P〈0．05）。结论右室梗死多见于中青年患者，多为右冠脉近端病变所致。右冠脉病变恶性缓慢型心律失常发生率高于左回旋支病变，且预后差于左回旋支病变。

Objective To investigate the clinical characteristics of different ischemic related coronary artery in patients with right ventricular infarction. Methods 32 patients with right ventricular myocardial infarc- tion admitted to our hospital from October 2007 to November 2013 were enrolled. According to the infarction related artery, the patients were divided into right coronary artery group（n=25 ） and left circumflex branch group（n=7）. The clinical data and results of coronary angiography were analyzed and compared. Results In right artery group, the lesions were all located in the proximal coronary artery, but the lesions in left circumflex branch group mainly located in mid-to-distal （P〈0.01）. The incidence of arrhythmia was higher in right artery group than left circumflex branch group （P〈0,05）. Conclusion In right ventricular myocardial infarction, patients with right coronary lesions have higher malignant type slow arrhythmia and with poor prognosisthan the left circumflex branch lesions.