无痛性心肌梗死52例临床分析  

A clinical analysis for 52 patients with painless myocardial infarction

作　　者：马秀萍 张友逊 赵新闻[2] 

机构地区：[1]山东省胶南市第三人民医院,266425 [2]山东省青岛市市立医院心内科,266000

出　　处：《疑难病杂志》2005年第3期135-137,共3页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探讨无痛性心肌梗死的临床特征。方法将116例急性心肌梗死患者根据有无胸痛分为胸痛组(CPMI)64例和无胸痛组(PMI)52例,比较2组的临床特征。结果PMI组与CPMI组比较,PMI组患者发病年龄较大(63.4岁±7.2岁对54.6岁±3.5岁),P<0.05;女性患者比例较大(51.9%对23.4%),P<0.001;伴有糖尿病者多(48.1%对32.8%),P<0.01;平均就诊时间晚(15.6h±2.4h对6.7h±3.1h),P<0.001;接受静脉溶栓者少(9.62%对53.13%),P<0.001;IRA再通率低(7.69%对67.19%),P<0.001;发生心功能不全、恶性心律失常、心源性休克等并发症多(44.23%对29.69%),P<0.01;住院5周病死率高(11.54%对4.69%),P<0.01。结论PMI组患者较CPMI组预后差,因此应及早诊断,有效治疗,改善预后。Objective To investigate the clinical characteristics of painless myocardial infarction.Methods 116 patients with acute myocardial infarction were divided into two groups according to whether they had chest pain or not. 64 patients in chest pain myocardial infarction group (CPMI) and 52 patients in painless myocardial infarction group (PMl),the clinical characteristics of the two group were compared.Results The age of pathogenesis in PMI group was significantly higher than that of CPMI group(63.4±7.2 vs 54.6±3.5,P<0.05);the ratio of female patients was also obviously higher than that of CPMI group(51.9% vs 23.4%,P<0.001);the patients complicated with diabetes was more than that of CPMI group(48.1% vs 32.86%,P<0.01); average visiting time was later than that of CPMI group(15.6 h±2.4 h vs 6.7 h±3.1 h,P<0.001);the patients who received venous thrombolytic therapy were less than those of CPMI group (9.62% vs 53.13%,P<0.001); complications including cardiac functional insufficiency,severe arrhythmia and cardiogenic shock were more than those of CPMI group (44.23% vs 29.69%,P<0.01);death rate after 5 weeks was higher than that of CPMI group (11.5% vs 4.69%,P<~0.01) .Conclusions The prognosis of PMI group is worse than that of CPMI group,so they should be diagnosed and treated early.

关 键 词：无痛性心肌梗死 临床分析 心肌梗死患者 恶性心律失常 临床特征 心功能不全 心源性休克 PMI 发病年龄 0.05 女性患者 就诊时间 静脉溶栓 有效治疗 改善预后 胸痛 再通率 IRA 并发症 病死率 预后差 早诊断 

分 类 号：R542.22[医药卫生—心血管疾病] R473.5[医药卫生—内科学]