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目的：了解急诊心电图ST段抬高病因，分析对急性心肌梗死和非心肌梗死鉴别方法。方法回顾性分析急诊117名心电图ST段抬高的患者病因及临床表现，实验室检查，总结动态复查心电图、CK-MB、胸痛胸闷症状在急性心肌梗死中的病例数，进行χ2统计分析。结果急诊117名患者心电图ST段抬高的病因其中：急性心肌梗死76例，占64.9%，早复极综合征9例，占7.7%，变异性心绞痛8例，占6.8%，病毒性心肌炎6例，占5.1%，肥厚性心肌病5例，占4.3%，急性胆囊炎、胆石症4例，占3.4%，急性心包炎3例，占2.6%，左心室肥厚2例，占1.7%室壁瘤2例，占1.7%，脑出血1例，占0.8%、急性胰腺炎1例，占0.8%。结论急诊心电图ST段抬高主要病因是急性心肌梗死，动态复查心电图、CK-MB、胸痛胸闷症状三者的联合诊断，是除冠状动脉造影以外诊断急诊心肌梗死实用方法。“,”Objective To investigate the etiology of emergency ECG ST segment elevation, analysis and identification methods of acute myocardial infarction and non myocardial infarction. Methods A retrospective analysis was performed on 117 cases of ST segment elevation etiology aged 35~93,and their laboratory examination . The analysis summarized number of cases of acute myocardial infarction through dynamic electrocardiogram, CK-MB, chest pain symptoms, and it was processed by adopting X2 statistical analysis. Results In the 117 cases of ECG ST segment elevation, there were 76 cases of acute myocardial infarction (64.9%),9 cases of early repolarization syndrome (7.7%),8 cases of variant angina (6.8%), 6 cases of viral myocarditis (5.1%), 5 cases of hypertrophic cardiomyopathy (4.3%);4 cases of acute cholelithiasis (3.4%),3 cases of acute pericarditis (2.6%),2 cases of left ventricular hypertrophy (1.7%),2 cases of ventricular aneurysm (1.7%), 1 case of cerebral hemorrhage (0.8%) and 1 case of acute pancreatitis (0.8%).Conclusion The main cause of ST segment elevation of ECG in emergency is acute myocardial infarction. Combined application of dynamic electrocardiogram, chest pain symptoms, and CK-MB are still effective diagnostic method of AMI in addition to coronary angiography.