目的 :观察并发右束支阻滞的急性心肌梗死 (AMI)患者的临床预后。方法 :将该院近 7年收治的2 39例AMI患者分为两组 :对照组 ,无新发的右束支阻滞 ;观察组 ,为伴有新出现的右束支阻滞。后者又根据右束支阻滞持续时间长短及是否并发其他传导阻滞分为 4个亚组。分析各组并发心功能不全、恶性室性心律失常及住院病死率的情况。结果 :观察组恶性室性心律失常的发生率、心功能受损及住院病死率分别为 19.0 %、4 7.6 %、30 .0 % ,较对照组相应的 3.0 %、19.8%、17.3%有显著增加 (P <0 .0 5 ) ;但后二者并非源自于单纯右束支阻滞 ,而与并发的其他传导阻滞有显著相关性 (P <0 .0 5 ) ;右束支阻滞持续时间周期对心功能受损及住院病死率的影响亦有明显相关性 (P <0 .0 5 )。结论 :伴随AMI新出现的右束支阻滞使患者的预后不良 Objective: To observe the clinical outcomes of patients with acute myocardial infarction (AMI) complicated by right bundle branch block. Methods: A total of 219 AMI patients admitted to the hospital for 7 years were divided into two groups: control group, with no new right bundle branch block; the observation group was accompanied by a new right bundle branch block. The latter is based on the right bundle branch block duration and whether or not complicated with other block is divided into four subgroups. Analysis of each group complicated with cardiac insufficiency, malignant ventricular arrhythmia and in-hospital mortality. Results: The incidence of malignant ventricular arrhythmias, impaired cardiac function and in-hospital mortality in the observation group were 19.0%, 7.6%, 30.0% respectively, which were significantly higher than 3.0%, 19.8% and 17.3% in the control group (P <0.05). However, the latter two were not caused by simple right bundle branch block, but significantly correlated with other conduction block (P <0.05). Right bundle branch block Hysteresis duration was also associated with impaired cardiac function and hospital mortality (P <0.05). CONCLUSION: The new right bundle branch block associated with AMI makes the patient’s prognosis poor