不典型急性心肌梗死的临床表现和心电图特点.docVIP

精品论文 参考文献 不典型急性心肌梗死的临床表现和心电图特点 蒋小花 王红 楚罗湘 邓靖 李婷婷 杨仕福 蒋微 　　(广西医科大学第四附属医院、柳州市工人医院，广西柳州，545005，) 　　[摘要］目的 探讨不典型急性心肌梗死（AMI）的临床表现和心电图特点，提高对不典型AMI的早期识别，改善预后。方法 选取60例不典型AMI患者为研究对象，将其临床症状、心电图以及治疗和转归进行回顾性分析和总结。结果 60例患者中以消化系统和呼吸系统症状为主，8.3%的患者无特征性表现。心电图检查结果中ST-T改变（无Q波型）占21.7%，小Q波占20%，进展性Q波占18.3%。经治疗后好转出院的患者43例（71.7%）；死亡患者17例（28.3%）。结论 不典型AMI的诊治应根据临床表现、心肌酶谱和心电图的动态演变进行综合诊断，以实现早期鉴别诊断，避免发生误诊。 　　[关键词］不典型急性心肌梗死；临床表现；心电图 　　Clinical manifestations and ECG characteristics of Atypical Acute Myocardial Infarction 　　Jiang xiaohua,Chu luoxiang,Deng jing,Li tingting,Yang shifu,Jiang wei. 　　(The Fourth affiliated hospital,Guang xi medical university, 　　Liuzhou Workers'Hospital,Liuzhou,Guangxi,545005,China) 　　【Abstract】Objective:This paper is to explore the clinical 　　manifestations and ECG characteristics of atypical acute myocardia infarction so as to improve the early detection and prognosis of atypical acute myocardia infarction(AMI).Method: Select60 cases of atypicalAMI patients in this study,and retrospectively analyze and summarize their clinical symptoms, ECG, treatments and prognosis.Results:Majority of the 60 patients have digestive and respiratory symptoms while 8.3% of these patients have no characteristic symptoms.Among their ECG results,21.7% of the patients have ST-T changes(non-Q waves),and 20% of them have small Q waves, and 18.3% of them have progressive Q waves. 43 (71.7%) of these patients were improved and discharged after treatment while 17(28.3 %) of them died. Conclusion: Diagnosis and treatment of atypical AMI patinets should be based on the comprehensive diagnosis of dynamic evolution of clinical manifestations, myocardial enzymes and ECG in order to achieve early diagnosis and avoid misdiagnosis.Myocardial enzymes and ECG in order to achieve early diagnosis and avoid misdiagnosis. 　　【Key words】atypical acute myocardial infarction；clinical manifestations；ECG 　　急性心肌梗死（AMI）是冠状动脉急性闭塞所致的心肌缺血、坏死。冠状动脉闭塞的最常见原因是在冠状动脉粥样硬化的基础上形成急性血栓。早期发现及时治疗对患者的预后影响意义巨大。典型的AMI主要症状是剧烈的胸骨后疼痛。但是