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例1 患者男,59岁。因受凉后反复卜腹胀痛4次,伴胸闷、背部及双上肢不适3天入院。心电图正常。既往无冠心病、心绞痛史。临床拟诊:心绞痛,胃、十二指肠炎。给予口服消心痛、胃酶等。入院后仅觉困乏,偶觉两肩背轻微不适,入院后第10天作ATP试验前,心电图(图1A)示V_1-V_3呈QS型,V_1、V_5呈rS型,ST_(V_2 V_6)弓背向上抬高0.1—0.3mV,T_(V_1 V6)倒置。心电图诊断:前间壁心肌梗塞。给予常规治疗。第11天18:00又出现前胸痛及两侧肩背痛伴胸闷。心电图(图1B)示ST_(V_2 V_5)较前抬高,V_4的r波消失,呈QS型,示心肌梗塞范围扩大。此后病情稳定,治疗8周出院。
Example 1 patient male, 59 years old. Abdominal pain caused by repeated cold 4 times, with chest tightness, back and upper limb discomfort 3 days admitted. Normal ECG. No previous coronary heart disease, history of angina. Clinical diagnosis: angina, stomach, duodenitis. Give oral anti-heartache, gastric enzymes and so on. Before admission to hospital for ATP test, the electrocardiogram (Figure 1A) showed V_1 -V_3 was QS type, V_1, V_5 was rS type, ST_ (V_2 V_6) Raise the back 0.1-0.3mV, T_ (V_1 V6) upside down. ECG diagnosis: anterior myocardial infarction. Give routine treatment. On the 11th day 18:00 there are chest pain and shoulder pain on both sides with chest tightness. ECG (Figure 1B) shows ST_ (V_2 V_5) higher than before, V_4 r wave disappeared, was QS-type, showing an increase in the scope of myocardial infarction. After a stable condition, 8 weeks of treatment were discharged.