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目的研究分析急性左心衰竭为主要表现的急性心肌梗死的临床特征。方法选取我院自2014年10月~2016年10月收治的急性左心衰竭为主要表现的急性心肌梗死患者44例作为研究对象,回顾患者的临床诊治资料,观察其左室射血分数和心功能变化等情况,分析总结急性左心衰竭的发病机制和原因。结果患者中,无痛性急性心肌梗死36例(81.8%);非ST段抬高型37例(84.1%);合并完全性左束支传导阻滞4例(9.1%)。超声心动图检查示,15例左室射血分数小于40%,约占总数的34.1%;29例左室射血分数在40%及以上,约占总数的65.9%。随访其中22例患者,发现5例在半年内死亡,约占随访总数的22.7%,此5例患者均合并糖尿病。结论急性左心衰竭为主要表现的急性心肌梗死多为无痛性急性心肌梗死和非ST段抬高型,左室收缩及舒张功能严重受损是引起心力衰竭的主要原因,合并糖尿病等是致死的主要原因。
Objective To study the clinical features of acute myocardial infarction (AMI), the main manifestation of acute left heart failure. Methods Forty-four acute myocardial infarction patients with acute left heart failure who were treated in our hospital from October 2014 to October 2016 were selected as the research objects. The clinical data of patients were reviewed and their left ventricular ejection fraction and heart Function changes, etc., analyze and summarize the pathogenesis and cause of acute left heart failure. Results Thirty-six patients (81.8%) had painless acute myocardial infarction, 37 patients (84.1%) had non-ST elevation disease, and 4 patients (9.1%) had complete left bundle branch block. Echocardiography showed that 15 cases left ventricular ejection fraction less than 40%, accounting for 34.1% of the total; 29 cases of left ventricular ejection fraction of 40% and above, accounting for 65.9% of the total. Of the 22 patients who were followed up, 5 patients were found dead within six months, accounting for 22.7% of the total. The 5 patients were all with diabetes mellitus. Conclusions Acute myocardial infarction with acute left heart failure is mostly painless acute myocardial infarction and non-ST-segment elevation type. Serious left ventricular systolic and diastolic dysfunction are the main causes of heart failure, with diabetes mellitus and other deaths The main reason.