Opolski G, Kraska T, Ostrzycki A, Zieliński T, Korewicki J
Int J Cardiol. 1986 Feb;10(2):141-7. doi: 10.1016/0167-5273(86)90222-6.
The effect of infarct size estimated from serial CK-MB isoenzyme determinations on the incidence of atrioventricular and intraventricular conduction disturbances was examined in 250 patients suffering their first myocardial infarction. The size of the infarct was significantly greater (P less than 0.001) in 72 patients with conduction disturbances than in 178 without conduction defects (54 +/- 29 vs. 35 +/- 22 CK-MB gEq). The largest size was observed in 10 patients with bifascicular block (71 +/- 38 CK-MB gEq). Within the group of patients with intraventricular conduction disturbances, the size of the infarct was significantly greater (P less than 0.01) when localized inferiorly rather than anteriorly (91 +/- 10 vs. 58 +/- 27 CK-MB gEq). The size in those patients with complete atrioventricular block and anterior infarction was larger than in those with an inferior lesion (76 +/- 21 vs. 52 +/- 33 CK-MB gEq). The size in those patients with inferior infarction and complete block was significantly greater (P less than 0.05) than in patients with similarly positioned infarction without conduction disturbances (52 +/- 33 vs. 35 +/- 22 CK-MB gEq). There was no significant difference in the size of infarct when inferior infarction was complicated by first- and second-degree block in comparison to those without conduction defects (38 +/- 23 vs. 35 +/- 22 CK-MB gEq). A correlation was observed between the size of infarction and the incidence of conduction disturbances (P less than 0.001); the greater the size the higher the incidence of conduction disturbances.
在250例首次发生心肌梗死的患者中，研究了根据连续测定肌酸激酶同工酶（CK-MB）评估的梗死面积对房室传导和室内传导障碍发生率的影响。72例有传导障碍的患者梗死面积显著大于（P<0.001）178例无传导缺陷的患者（54±29 vs. 35±22 CK-MB克当量）。10例双分支阻滞患者的梗死面积最大（71±38 CK-MB克当量）。在室内传导障碍患者组中，梗死位于下壁时的面积显著大于（P<0.01）位于前壁时（91±10 vs. 58±27 CK-MB克当量）。完全性房室传导阻滞合并前壁梗死患者的梗死面积大于合并下壁病变的患者（76±21 vs. 52±33 CK-MB克当量）。下壁梗死合并完全性阻滞患者的梗死面积显著大于（P<0.05）同样部位无传导障碍的梗死患者（52±33 vs. 35±22 CK-MB克当量）。下壁梗死合并一度和二度阻滞时的梗死面积与无传导缺陷者相比无显著差异（38±23 vs. 35±22 CK-MB克当量）。梗死面积与传导障碍发生率之间存在相关性（P<0.001）；梗死面积越大，传导障碍发生率越高。
