113例老年糖尿病患者合并无痛性急性心肌梗死的心电图特点及临床表现  

Clinical manifestations and ECG features of 113 elderly diabetics with painless acute myocardial infarction

作　　者：时慧 李冬娟 孟庆慧 杨丽 

机构地区：[1]枣庄矿业集团中心医院心功能科,山东枣庄277000 [2]枣庄矿业集团中心医院老年病科,山东枣庄277000

出　　处：《实用心电学杂志》2015年第6期446-448,共3页Journal of Practical Electrocardiology

摘　　要：目的探讨糖尿病患者合并无痛性急性心肌梗死的心电图特点及临床表现。方法选择老年糖尿病合并急性心肌梗死患者262例,分为胸前区无痛组(A组)113例、疼痛组(B组)149例,对两组患者的临床资料及心电图进行对比分析。结果 A组梗死以下壁多见,ST段抬高及梗死部位比B组多,B组梗死以前壁最多见,两组比较差异有统计学意义(P<0.05)。A组胸痛、心悸、晕厥的发生率较B组低,差异有统计学意义(P<0.05)。A组胸闷、气短、牙痛、恶心呕吐的发生率较B组高,差异有统计学意义(P<0.05)。A组病死率高于B组,差异有统计学意义(P<0.05)。结论老年糖尿病患者合并无痛性急性心肌梗死的临床症状不典型导致就诊时间晚,病死率高。临床医师应提高对老年糖尿病患者合并无痛性急性心肌梗死的认识,以便于降低死亡率、提高治愈率。Objective To investigate the electrocardiogram（ECG） features and clinical manifes- tations of diabetics with painless acute myocardial infarction （AMI）. Methods Two hundred and sixty-two diabetics with AMI were selected, and divided into chest painless group （113 cases, group A） and pain group（ 149 cases, group B） separately. The clinical data and ECGs of the two groups were comparatively analyzed. Results In group A, infarcts were mainly observed in inferior wall, and the locations of ST-segment elevation and infarct were more than those in group B. In group B, the majority of infarcts occurred in front wall. The differences between the two groups were statisti- cally significant（ P 〈 0.05 ）. The incidences of chest pain, palpitation and syncope in group A were lower than those in group B, with statistically significant differences （ P 〈 0.05 ）. The incidences of shortness of breath, toothache and nausea in group A were higher than those in group B, with statis- tically significant difference （ P 〈 0.05 ）. The fatality rate of group A was higher than that of group B, with statistically significant differences （P 〈 0.05 ）. Conclusion For the uncharacteristic clini- cal symptoms of diabetes complicating painless AMI in elderly people, the visiting time is prone to be postponed, partly resulting in high fatality rate. Clinicians should raise the understanding of dia- betes complicating painless AMI, in order to reduce mortality and increase cure rate.

关 键 词：老年糖尿病 无痛性急性心肌梗死 心电图 

分 类 号：R540.41[医药卫生—心血管疾病]