目的 探讨急性心肌梗死伴或不伴右束支阻滞患者的动态心电图室性早搏Lown分级与微伏级T波电交替(Microvolt T wave alternans
MTWA)的差异。方法 选取2017-2021年在粤北人民医院住院并行PCI治疗的215例急性心肌梗死患者,依据心电图是否合并右束支阻滞分为右束支组和非右束支组,其中右束支组64例,非右束支组151例。采用1:1倾向性评分匹配法匹配两组的基线资料以均衡组间协变量。匹配后对两组间的动态心电图室早Lown分级和MTWA结果进行比较。结果 共53对完成倾向性评分匹配,经匹配两组间基线资料达到基本平衡。匹配后,右束支组室早Lown中、高危分级有28例(43.4%),高于非右束支组,10例(18.9%),差异有统计学意义(P<0.05)。右束支组MTWA的阳性率为26.4%,非右束支组为7.5%,差异有统计学意义(P<0.05)。结论 与非右束支组相比,急性心肌梗死伴右束支阻滞患者的Lown中、高危分级及MTWA阳性率更高,发生恶性室性心律失常的风险较高。
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