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目的研究完全性左束支传导阻滞(CLBBB)合并心血管疾病患者的临床特点。方法回顾性分析2001年1月至2010年1月520例CLBBB入住六安市人民医院心内一科患者资料,对比冠心病和非冠心病患者的临床特点,通过统计学相关方法分析找出CLBBB患者中与冠心病相关的独立预测因素。结果 520例左束支传导阻滞患者中合并高血压性心脏病、冠心病和扩张型心肌病者分别占50.3%、42.3%和27.7%,合并各类型心律失常者29.9%。多元回归分析结果:年龄≥66岁(P<0.01,B=2.753,95%CI:1.736～4.003)、高血压(P=0.022,B=1.522,95%CI:1.062-1.640)、2型糖尿病(P<0.001,B=2.469,95%CI:1.325～3.756)、高脂血症(P=0.8013,B=1.057,95%CI:0.602～1.630)与冠心病的发生率呈正相关,而扩张型心肌病(P<0.001,B=0.062,95%CI:0.05～0.137)、心脏瓣膜病(P=0.027,B=0.0296,95%CI:0.065～0.803)、心房颤动及心房扑动(P=0.0225,B=0.514,95%CI:0.303～0.920)、其他各种类型的传导阻滞(P<0.001,B=0.408,95%CI:0.259～0.605)与冠心病的发生率呈负相关。结论合并完全性左束支传导阻滞患者中,年龄≥66、高血压、2型糖尿病患者容易合并冠心病;而扩张型心肌病、心房颤动或心房扑动在未合并冠心病的完全性左束支传导阻滞患者中更常见。
Objective To study the clinical features of patients with complete left bundle branch block (CLBBB) and cardiovascular diseases. Methods A retrospective analysis of 520 cases of CLBBB admitted to Lu’an People’s Hospital from January 2001 to January 2010 was performed to compare the clinical features of patients with coronary heart disease and non-coronary heart disease and to find CLBBB by statistical analysis Independent predictors of coronary heart disease in patients. Results 520 cases of left bundle branch block patients with hypertensive heart disease, coronary heart disease and dilated cardiomyopathy accounted for 50.3%, 42.3% and 27.7%, with all types of arrhythmia 29.9%. Multivariate regression analysis showed that patients aged ≥66 years (P <0.01, B = 2.753, 95% CI: 1.736-4.003), hypertension (P = 0.022, B = 1.522, 95% CI: 1.062-1.640), type 2 diabetes (P = 0.001, B = 2.469, 95% CI: 1.325-3.756). There was a positive correlation between the incidence of coronary heart disease and hyperlipidemia (P = 0.8013, B = 1.057, 95% CI: 0.602-1.630) (P = 0.001, B = 0.062, 95% CI: 0.05-0.13), valvular heart disease (P = 0.027, B = 0.0296, 95% CI: 0.065-0.803), atrial fibrillation and atrial flutter = 0.0225, B = 0.514, 95% CI: 0.303-0.920). The incidence of coronary heart disease was negatively correlated with other types of conduction block (P <0.001, B = 0.408, 95% CI: 0.259-0.605) . Conclusions In patients with complete left bundle branch block, patients with age≥66, hypertension and type 2 diabetes are likely to have coronary heart disease. However, dilated cardiomyopathy, atrial fibrillation, or atrial flutter are not significantly associated with complete left Bundle branch block is more common in patients.