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目的:探讨束支传导阻滞(BBB)对接受经皮冠状动脉介入治疗(PCI)的急性冠状动脉综合征(ACS)患者预后的影响.方法:本研究纳入2013-01至2013-12于中国医学科学院阜外医院行PCI的ACS患者6429例.根据出院诊断中是否包含BBB,将患者分为BBB组(n=159)和非束支传导阻滞(NBBB)组(n=6270),分析比较两组2年主要不良心脑血管事件(MACCE,包括全因死亡、心原性死亡、心肌梗死、血运重建、支架内血栓形成、脑卒中)发生率的差异,并评估BBB与行PCI的ACS患者临床结局的相关性.结果:BBB组患者年龄较NBBB组更高[(62.97±11.37)岁 vs (58.26±10.36)岁],体重指数更低[(25.31±3.02) kg/m2vs (25.89±3.20)kg/m2],肾小球滤过率[(86.89±16.15)ml/min vs (91.05±15.53)ml/min]和左心室射血分数[(59.27±9.86)% vs (62.37±7.36)%]更低,组间比较差异均有统计学意义(P均0.05).2年随访时,BBB组的心原性死亡(2.5% vs 0.7%)和支架内血栓形成(3.1% vs 0.8%)发生率均显著高于NBBB组(P均0.05).但经倾向性评分调整后,2年随访时两组的MACCE发生率差异无统计学意义(P>0.05),BBB组中的左束支传导阻滞患者、右束支传导阻滞患者与NBBB患者在所有MACCE发生率上的差异也均无统计学意义(P均>0.05).Cox回归分析提示,合并BBB与PCI后ACS患者临床结局无明显关联.结论:对于行PCI的ACS患者,BBB并不是远期MACCE的独立危险因素.“,”Objective: To explore the impact of bundle branch block (BBB) on acute coronary syndrome (ACS) prognosis in patients after percutaneous coronary intervention (PCI). Methods: A total of 6 429 ACS patients received PCI in our hospital from 2013-01 to 2013-12 were enrolled. According to BBB diagnosis at discharge, the patients were divided into 2 groups: BBB group, n=159 and Non-BBB group, n=6 270. The incidences of 2-year major adverse cardio and cerebral-vascular events (MACCE) including all-cause death, cardiac death, myocardial infarction, revascularization, in-stent thrombosis and stroke were compared between 2 groups; relationship between existing BBB and clinical outcomes was assessed. Results: Compared with Non-BBB group, BBB group had the elder age (62.97±11.37) years vs (58.26±10.36) years, lower BMI (25.31±3.02) vs (25.89±3.20), decreased glomerular filtration rate (86.89±16.15)ml/min vs (91.05±15.53)ml/min and LVEF (59.27±9.86)% vs (62.37±7.36) %, all P0.05. During 2-year follow-up period, compared with Non-BBB group, BBB group showed the higher incidences of cardiac death (2.5% vs 0.7%) and in-stent thrombosis (3.1% vs 0.8%), both P0.05. With adjusted propensity score matching, 2-year incidence of MACCE was similar between 2 groups, P>0.05; 2-year incidences of MACCE in BBB group including LBBB and RBBB were similar to Non-BBB group, P>0.05. Cox regression analysis revealed that BBB was not related to ACS prognosis after PCI. Conclusion: BBB was not an independent risk factor for long-term MACCE occurrence in ACS patients after PCI.