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目的探讨心肌梗死(AMI)合并新发一过性右束支阻滞(RBBB)相关因素。方法收集AMI合并新发RBBB阻滞患者107例,根据RBBB是否院内消失将其分为新发持续RBBB组和新发一过性RBBB组。比较两组间的基线资料、院内预后;应用关联性分析研究AMI合并新发RBBB患者RBBB消失与接受接诊治疗时间相关性;应用Logistic回归筛选新发RBBB院内消失独立预测因素。结果与新发持续RBBB相比,新发一过性RBBB患者年龄、心功能受损程度及梗死面积相对较小,院内不良心脏事件(MACE)的发生率较低,且接受急诊介入治疗的比率较高;新发RBBB院内消失比率与急诊介入治疗时间呈负相关,Pearson相关系数r=-0.943;Logistic回归分析筛选新发RBBB院内消失与年龄、心肌酶峰值、Killip分级≥2呈负相关,与接受急诊介入治疗呈正相关。结论 AMI合并一过性RBBB较持续RBBB预后较好,新发RBBB院内消失比率与急诊介入治疗存在明显相关性。
Objective To investigate the related factors of myocardial infarction (AMI) combined with new onset of right bundle branch block (RBBB). Methods A total of 107 patients with AMI combined with newly diagnosed RBBB block were enrolled in this study. They were divided into new continuous RBBB group and new onset transient RBBB group according to whether in-hospital RBBB disappeared. Baseline data and in-hospital prognosis were compared between the two groups. Correlation analysis was used to investigate the relationship between disappearance of RBBB and the time of receiving admissions in AMI patients with newly diagnosed RBBB. Logistic regression was used to screen independent predictors of disappearance of newly diagnosed RBBB in hospital. Results Compared with new RBBB, the newly diagnosed RBBB patients had relatively lower age and heart function impairment and infarct size. The incidence of adverse cardiac events (MACE) in hospital was lower and the rate of emergency intervention ; The rate of disappearance of newly diagnosed RBBB in hospital was negatively correlated with the time of emergency intervention, Pearson correlation coefficient was -0.943; Logistic regression analysis showed that the disappearance of newly diagnosed RBBB in hospital was negatively correlated with age, peak of myocardial enzymes, Killip grade≥2, And received emergency intervention was positively correlated. Conclusions AMI combined with transient RBBB has a better prognosis than continuous RBBB. The rate of disappearance of newly diagnosed RBBB in hospital is significantly correlated with emergency intervention.