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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 2 2 .8% )。并心衰组较无心衰组年龄大〔6 5 .3± 10 .8)岁∶ (6 1.1± 10 .1)岁〕、肌酸激酶 (CK)峰值高〔(2 70 0 .4± 2 0 87.7) IU / L∶ (1879.1± 16 0 3.1) 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～ 6 ST段压低为主者比例高 (5 6 .1%∶ 2 4.5 % ) ,住院病死率高(4 6 .3%∶ 17.3% )。 L ogistic回归分析显示 AIMI并心衰与 CK峰值、右室梗死、胸前导联 V4～ 6 ST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。
Objective: To analyze the clinical characteristics and prognosis of acute inferior myocardial infarction (AIMI) and heart failure (heart failure). Methods: The clinical features and in-hospital complications of 180 patients with AIMI were retrospectively analyzed. The conventional 12-lead electrocardiogram and right chest lead electrocardiogram were recorded and compared with those without heart failure. Results: AIMI and heart failure in 41 cases (22.8%). Compared with those without heart failure, the peak value of creatine kinase (CK) in heart failure group was (65.3 ± 10.8) years old: (61.1 ± 10.1) years old 〔(2 70 ± 4) ± The incidence of right ventricular infarction (31.7% vs 5.8%) and height atrioventricular block (39.0%: 17.3%) were high in 2 0 87.7 IU / L patients, Thoracic aorta V4 ~ 6 ST segment depression was the main proportion of high (56.1%: 24.5%), hospital mortality was high (46.3%: 17.3%). L ogistic regression analysis showed that AIMI and heart failure were independently associated with CK peak, right ventricular infarction, V4 ~ 6 ST segment depression and mortality, but not with age and height atrioventricular block. Conclusion: AIMI and heart failure chest V4 ~ 6 lead ST segment depression and the incidence of right ventricular infarction, high CK peak. AIMI and heart failure hospitalized high mortality, poor prognosis, as a high-risk subgroup.