中国循证心血管医学杂志
中國循證心血管醫學雜誌
중국순증심혈관의학잡지
CHINESE JOURNAL OF EVIDENCE-BASES CARDIOVASCULAR MEDICINE
2013年
5期
498-499
,共2页
代政学%严鹏飞%冯大跃%王善慧%李金明%田少华%白春荣%任敏%张丽娜%李俊侠
代政學%嚴鵬飛%馮大躍%王善慧%李金明%田少華%白春榮%任敏%張麗娜%李俊俠
대정학%엄붕비%풍대약%왕선혜%리금명%전소화%백춘영%임민%장려나%리준협
下壁心肌梗死%右心室心肌梗死%临床特征
下壁心肌梗死%右心室心肌梗死%臨床特徵
하벽심기경사%우심실심기경사%림상특정
Inferior wall myocardial infarction%Right ventricular myocardial infarction
目的：比较急性下壁心肌梗死（IWMI）伴或不伴右心室心肌梗死（RVMI）患者的临床特征差异。方法纳入2006年10月~2012年12月总参保健处发病12 h内入院的急性下壁心肌梗死（IWMI）患者256例，根据冠状动脉造影（CAG）结果将患者分为IWMI不合并RVMI组（n=167）和IWMI合并RVMI组（n=89），比较两组患者冠心病发病主要危险因素（包括吸烟、高血压、糖尿病、高脂血症、冠心病家族史）、临床表现、并发症和治疗用药的差异。结果两组患者冠心病主要危险因素无差异（P＞0.05）。IWMI合并RVMI患者出现低血压（80.0% vs.19.8%，P＜0.05）、颈静脉怒张（50.6%vs.1.8%）和Kussmaul征（51.7%vs.1.2%）的比例明显增加（P均＜0.01），需要更多地应用正性肌力药物（60.7%vs.16.2%）来维持血压，且病死率较高（77.9%vs.0.6%，P＜0.05）。结论在IWMI基础上伴RVMI多合并右心功能障碍，可导致预后不良。
目的：比較急性下壁心肌梗死（IWMI）伴或不伴右心室心肌梗死（RVMI）患者的臨床特徵差異。方法納入2006年10月~2012年12月總參保健處髮病12 h內入院的急性下壁心肌梗死（IWMI）患者256例，根據冠狀動脈造影（CAG）結果將患者分為IWMI不閤併RVMI組（n=167）和IWMI閤併RVMI組（n=89），比較兩組患者冠心病髮病主要危險因素（包括吸煙、高血壓、糖尿病、高脂血癥、冠心病傢族史）、臨床錶現、併髮癥和治療用藥的差異。結果兩組患者冠心病主要危險因素無差異（P＞0.05）。IWMI閤併RVMI患者齣現低血壓（80.0% vs.19.8%，P＜0.05）、頸靜脈怒張（50.6%vs.1.8%）和Kussmaul徵（51.7%vs.1.2%）的比例明顯增加（P均＜0.01），需要更多地應用正性肌力藥物（60.7%vs.16.2%）來維持血壓，且病死率較高（77.9%vs.0.6%，P＜0.05）。結論在IWMI基礎上伴RVMI多閤併右心功能障礙，可導緻預後不良。
목적：비교급성하벽심기경사（IWMI）반혹불반우심실심기경사（RVMI）환자적림상특정차이。방법납입2006년10월~2012년12월총삼보건처발병12 h내입원적급성하벽심기경사（IWMI）환자256례，근거관상동맥조영（CAG）결과장환자분위IWMI불합병RVMI조（n=167）화IWMI합병RVMI조（n=89），비교량조환자관심병발병주요위험인소（포괄흡연、고혈압、당뇨병、고지혈증、관심병가족사）、림상표현、병발증화치료용약적차이。결과량조환자관심병주요위험인소무차이（P＞0.05）。IWMI합병RVMI환자출현저혈압（80.0% vs.19.8%，P＜0.05）、경정맥노장（50.6%vs.1.8%）화Kussmaul정（51.7%vs.1.2%）적비례명현증가（P균＜0.01），수요경다지응용정성기력약물（60.7%vs.16.2%）래유지혈압，차병사솔교고（77.9%vs.0.6%，P＜0.05）。결론재IWMI기출상반RVMI다합병우심공능장애，가도치예후불량。
Objective To analyze the clinical characteristics of acute inferior wall myocardial infarction (IWMI) accompanied by or without right ventricular myocardial infarction (RVMI). Methods The patients (n=256) with IWMI hospitalized within 12 h after disease onset were chosen and divided into group without RVMI (n=167) and group of IWMI accompanied by RVMI (n=89) according to outcomes of CAG. The differences in major risk factors (smoking, hypertension, diabetes, hyperlipidemia and family history of coronary heart disease), clinical symptoms, complications and drug administration were analyzed and compared in two groups. Results There were no differences in major risk factors in two groups. The percentages of hypotension (80.0%vs. 19.8%, P<0.05), distension of jugular vein (50.6%vs. 1.8%) and Kussmaul sign (51.7%vs. 1.2%) were higher in group of IWMI accompanied by RVMI (P<0.01). More positive inotropic drugs (60.7%vs. 16.2%) were needed for keeping blood pressure, and morality (77.9%vs. 0.6%, P<0.05) was higher in group of IWMI accompanied by RVMI. Conclusion IWMI accompanied by RVMI is commonly complicated with right heart failure, which will induce poor prognosis.
