近年来,急性心肌梗塞(AMI)的诊断和治疗有了很大的进展,国内外病死率均有明显的降低。陶寿琪报道其病死率已由30%降至10—15%。本文总结分析三年内(1977—1980)所收治54例AMI临床资料,并对降低病死率问题做初步探讨。临床资料:本组男性43例(79.63%),女性11例(20.37%),男女之比为4.27:1。发病年龄41—86岁,平均58.2岁。发病后入院时间1—96小时,平均22.2小时。本组先驱症状发生率为76.63%,以频繁心绞痛多见(38.8%)。此外,还有持续性胸闷、上腹部不适伴恶心呕吐或心慌气短及呼吸困难等症候群。按临床症状分为心绞痛型、胃肠型、昏迷型和休克型,以心绞痛型多见(72.2%)。心脏异常体征多见心界扩大、心音减弱、期前收缩和心尖部Ⅱ级以上收缩期杂音,特别第一心音减弱更为常见(72.2%)。本组有并发症39例(72.2%),其中并有心律失常、休克和心衰者分别为28例(71.8%)、18例(33.3%)、16例(29.6%)。梗塞部位与并发症发生有密切关系,下壁AMI并发症发生率高(100%),其中以心律失常 In recent years, acute myocardial infarction (AMI) diagnosis and treatment has made great progress, both at home and abroad have significantly reduced mortality. Tao Shouqi reported that the case fatality rate has dropped from 30% to 10-15%. This article summarizes the clinical data of 54 cases of AMI admitted in three years (1977-1980), and makes a preliminary discussion on the reduction of mortality. Clinical data: The group of 43 males (79.63%), 11 females (20.37%), male to female ratio was 4.27: 1. Age onset 41-86 years old, with an average of 58.2 years old. After onset of admission 1-96 hours, an average of 22.2 hours. The incidence of this group of pioneer symptoms was 76.63%, with frequent angina more common (38.8%). In addition, there are persistent chest distress, upper abdominal discomfort with nausea and vomiting or palpitation shortness of breath and dyspnea and other symptoms. According to clinical symptoms are divided into angina type, gastrointestinal type, coma and shock type, with angina type more common (72.2%). Symptoms of abnormal heart more common psychological expansion, decreased heart sounds, systolic and atrial systolic grade Ⅱ above systolic murmur, especially the first heart sound weakened more common (72.2%). This group had complications in 39 cases (72.2%), of which arrhythmia, shock and heart failure were 28 cases (71.8%), 18 cases (33.3%), 16 cases (29.6%). Infarction is closely related to the occurrence of complications, the incidence of complications of inferior wall AMI (100%), of which arrhythmia