急性下壁心肌梗死时发生右束支传导阻滞的临床意义

The frequency and clinical significance of right buddle branch block inferior myocardial infarction

对116例急性下壁心肌梗死的心电图分析显示,并右室梗死组右束支传导阻滞(RBBB)发生率显著高于无右室梗死组(48％对9％P<0.01)。急性下壁心肌梗死并RBBB时≥2°房室传导阻滞、心室颤动,心性休克、血清CK峰值、住院死亡率均显著增高。提示RBBB的发生与梗死面积大有关,预后较差。

ECGs of 116 patients with inferior wall acute myocardial infarction had been studied. It was shown that the incidence of RBBB was significantly higher in patients with inferior wall infarction involving right ventricle as compared to patients only with an inferior wall infarction(48% to 9%, P<0.01). As compared with patients without RBBB, the incidence of more than 2 AV block, ventricular fibrillation, cardiogenic shock and other complications in patients with RBBB phosphokinase was also higher(376.1±126.8 vs 301.4±144.5,P<0.05). The in-hospital death rate was higher in group with RBBB(17% vs 2%,P<0.01). Therefore,we conclude that the RBBB with acute inferior wall myocardial infarction identifies more extensive infarction size and poorer prognosis.