不典型急性心肌梗死的临床特点及早期识别  

Clinical Characteristics and Early Identification of Atypical Acute Myocardial Infarction

作　　者：莫税宁[1] 

机构地区：[1]南宁市第二人民医院,530031

出　　处：《临床心电学杂志》2015年第3期190-192,共3页Journal of Clinical Electrocardiology

摘　　要：目的探究不典型急性心肌梗死的临床特点,以实现临床早期鉴别诊断。方法研究对象为80例不典型急性心肌梗死患者,采用回顾性分析的研究方式归纳总结患者的治疗资料,重点探究其临床特点和早期特异性表现。结果 80例患者中呼吸系统症状占20.00%,循环系统症状占18.75%,消化系统症状占42.50%,神经系统症状占16.25%,2.50%的患者无特征性表现。心电图检查结果中急性非Q波心肌梗死占46.25%,急性Q波性心肌梗死占53.75%。心肌酶谱检查异常升高患者占97.50%。31.25%患者在6h内确诊,47.50%患者在6h^12h确诊,21.25%患者在12h后确诊。经治疗后好转率总有效率为87.50%,总无效率为12.5%,死亡率为7.50%。结论急性心肌梗死患者具有不典型心电图表现,但心肌酶谱检查具有较高的敏感性,临床诊治中可结合进行诊断,以实现早期鉴别诊断,辅助治疗,促进病情预后。Objective This paper is to explore clinical characteristics of atypical acute myocardial infarction so as to realize early clinical differential diagnosis. Methods The research subjects were 80 patients with atypical acute myocardial infarction, the research method of retrospective analysis was applied to sum up the treatment data of patients, and clinical characteristics and early specificity performance was intensively explored. Results The proportion of patients with respiratory symptoms, circulatory system symptoms, digestive system symptoms and nervous system symptoms accounted for 20.00%, 18.75% and 42.50% respectively, and 2.50% of patients showed no manifestations of symptoms. The proportion patients with acute non-Q wave myocardial infarction and acute q-wave myocardial infarction accounted for 46.25% and 53.75% respectively in examination results of ECGs. The proportion of patients with abnormal increase in the examination of myocardial enzyme spectrum accounted for 97.50%. 31.25% of patients were confirmed within 6h. 47.50% of patients were confirmed within 6 hours and 12 hours. 21.25% of patients were confirmed after 12 hour. The total effective rate, total no efficiency and the mortality rate accounted for 87.5%, 12.5% and 7.50% respectively. Conclusions Patients with acute myocardial infarction have atypical manifestations of ECGs, but examinations of myocardial enzyme spectrum delivers high sensitivity, and combined diagnosis can be realized in clinical diagnosis and treatment in order to realize early differential diagnosis and auxiliary treatment to promote disease prognosis.

关 键 词：不典型急性心肌梗死 临床特点 早期识别 

分 类 号：R542.22[医药卫生—心血管疾病] R540.41[医药卫生—内科学]