CAJ | 학술논문

目的：分析急性下壁心肌梗死(AIMI)并心力衰竭(心衰)的临床特征及预后。方法：记录180例AIMI患者中并心衰者的临床特征及住院并发症，行常规12导联心电图及右胸导联心电图，并与无心衰者比较。结果：AIMI并心衰者41例(占22.8%)。并心衰组较无心衰组年龄大〔65.3±10.8)岁∶(61.1±10.1)岁〕、肌酸激酶(CK)峰值高〔(2 700.4±2 087.7)IU/L∶(1 879.1±1 603.1) IU/L〕，右室梗死 (31.7%∶5.8%)及高度房室传导阻滞(39.0%∶17.3%)发生率高，胸前导联V4～6ST段压低为主者比例高(56.1%∶24.5%)，住院病死率高(46.3%∶17.3%)。Logistic回归分析显示AIMI并心衰与CK峰值、右室梗死、胸前导联V4～6ST段压低及死亡率独立相关，而与年龄及高度房室传导阻滞不相关。结论：AIMI并心衰者胸前V4～6导联ST段压低及右室梗死发生率高，CK峰值高。AIMI并心衰住院病死率高，预后差，为一高危亚组。
목적：분석급성하벽심기경사(AIMI)병심력쇠갈(심쇠)적림상특정급예후。방법：기록180례AIMI환자중병심쇠자적림상특정급주원병발증，행상규12도련심전도급우흉도련심전도，병여무심쇠자비교。결과：AIMI병심쇠자41례(점22.8%)。병심쇠조교무심쇠조년령대〔65.3±10.8)세∶(61.1±10.1)세〕、기산격매(CK)봉치고〔(2 700.4±2 087.7)IU/L∶(1 879.1±1 603.1) IU/L〕，우실경사 (31.7%∶5.8%)급고도방실전도조체(39.0%∶17.3%)발생솔고，흉전도련V4～6ST단압저위주자비례고(56.1%∶24.5%)，주원병사솔고(46.3%∶17.3%)。Logistic회귀분석현시AIMI병심쇠여CK봉치、우실경사、흉전도련V4～6ST단압저급사망솔독립상관，이여년령급고도방실전도조체불상관。결론：AIMI병심쇠자흉전V4～6도련ST단압저급우실경사발생솔고，CK봉치고。AIMI병심쇠주원병사솔고，예후차，위일고위아조。
Objective：To analyse the clinical features and in-hospital prognosis of patients with acute inferior myocardial infarction (AIMI)complicated by heart failure.Method：One hundred and eighty consecutive patients with AIMI were analyzed. The clinical characteristics and in-hospital mortalities of groups of patients with and without heart failure during AIMI were compared.Result：Among 180 AIMI patients,41 patients(22.8%) were complicated by heart failure. Compared with patients without heart failure, patients with heart failure were older(65.3±10.8 versus 61.1±10.1 years,P<0.05) and had a higher peak level of creatine kinase 〔(2 700.4±2 087.7) versus (1 879.1±1 603.1) IU/L,(P<0.05)〕,a greater involvement of right ventricle(31.7% versus 5.8%,P<0.001),more advanced atrioventricular block(39.0% versus 17.3%,P<0.05),greater incidence of ST-segment depression of V4～6 precordial leads(56.1% versus 24.5%,P<0.01) and a higher in-hospital mortality(46.3% versus 17.3%,P<0.001).Logistic analyses found that heart failure was related to peak level of creatine kinase, involvement of right ventricle, in-hospital mortality and incidence of ST-segment depression of V4～6 precordial leads, but had no relation to age and advanced atrioventricular block.Conclusion：Patients with heart failure complicating AIMI had a higher incidences of ST-segment depression of V4～6 precordial leads and involvement of right ventricle as well as a higher peak level of creatine kinase. Groups with heart failure had a higher mortality, therefore, patients with heart failure complicating AIMI are a high risk group and have worse in-hospital prognosis.