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[基于个人观察的右心室心肌梗死]

[Right ventricle myocardial infarction from personal observations].

作者信息

Słowiński S, Moszczyński P, Januś B, Smołucha A

机构信息

Oddziału Kardiologicznego Wojewódzkiego Szpitala Zespolonego im. E. Szczeklika w Tarnowie.

出版信息

Przegl Lek. 1999;56(4):263-6.

Abstract

In 2514 patients with myocardial infarction (1961 male and 823 female) hospitalized between 1991 and 1997 right ventricle myocardial infarction was diagnosed based on of V3R-V5R electrocardiographic leads tracing in 147 patients aged 35-86 (105 male and 42 female), which means 5.4% of treated patients. Only one case of isolated right ventricle infarction was observed. In other cases it coexisted with left ventricle infarction--most often with inferior myocardial infarction (118 cases, which means 10.7% cases with this localization). Streptokinase was administered to 64 patients with right ventricle infarction, which means 43.5% treated. 10 patients, including 5 female, deceased during the hospitalization, hospital mortality was 6.8%. Cardiogenic shock was the reason of death in all cases. The frequency of concomitant chronic diseases (hypertension, congestive heart failure, diabetes mellitus) and hyperlipidaemia (hypercholesterolaemia and/or hypertriglyceridaemia), as well as arrhythmia and conduction disturbances, in patients with right ventricle myocardial infarction did not differ from the ones estimated in people with left ventricle infarction. According to the analysis of our own material (the most numerous group of patients as juxtaposed to ones observed by other authors) inferior myocardial infarction is most commonly accompanied by right ventricle infarction. Low hospital mortality in these patients is connected with fibrinolytic therapy. The performance of V3R-V5R electrocardiographic leads tracing is indispensable in patients with acute myocardial infarction. The diagnosis of right ventricle infarction is highly important because of the specific treatment of these patients.

摘要

在1991年至1997年期间住院的2514例心肌梗死患者(1961例男性和823例女性)中,根据V3R - V5R心电图导联描记,在147例年龄35 - 86岁的患者(105例男性和42例女性)中诊断出右心室心肌梗死,占治疗患者的5.4%。仅观察到1例孤立性右心室梗死。在其他病例中,它与左心室梗死并存,最常见的是与下壁心肌梗死并存(118例,占该部位病例的10.7%)。64例右心室梗死患者接受了链激酶治疗,占治疗患者的43.5%。10例患者在住院期间死亡,其中包括5例女性,医院死亡率为6.8%。所有病例的死亡原因均为心源性休克。右心室心肌梗死患者中合并慢性疾病(高血压、充血性心力衰竭、糖尿病)和高脂血症(高胆固醇血症和/或高甘油三酯血症)以及心律失常和传导障碍的频率与左心室梗死患者的估计频率没有差异。根据我们自己的资料分析(与其他作者观察的患者相比,我们的患者组数量最多),下壁心肌梗死最常伴有右心室梗死。这些患者较低的医院死亡率与纤维蛋白溶解疗法有关。对于急性心肌梗死患者,进行V3R - V5R心电图导联描记是必不可少的。由于这些患者的特殊治疗,右心室梗死的诊断非常重要。

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