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目的探讨不典型急性心肌梗死(AMI)的临床特点,减少AMI的误诊、漏诊,做到早诊断、早治疗。方法对2003年1月至2013年12月在郏县人民医院就诊的200例不典型AMI患者的临床资料进行回顾性分析。结果病例分析中因AMI发作时症状不典型而被误诊为心力衰竭、心律失常、消化道、呼吸系统、脑血管、神经系统及口腔等疾病。在结合详细询问病史、观察心电图和(或)心肌酶学的动态演变得到确诊,使患者得到积极有效的合理治疗,降低了患者的临床病死率。结论应提高对不典型AMI的认识,要结合临床症状、体征、心电图和心肌酶学检查,降低不典型AMI的误诊率,争取早诊断、早治疗,改善患者预后。
Objective To investigate the clinical features of atypical acute myocardial infarction (AMI) and to reduce the misdiagnosis and missed diagnosis of AMI so as to make early diagnosis and early treatment. Methods The clinical data of 200 patients with atypical AMI who were treated in Shexian People’s Hospital from January 2003 to December 2013 were retrospectively analyzed. Results In the case analysis, patients were misdiagnosed as heart failure, arrhythmia, digestive tract, respiratory system, cerebrovascular, nervous system and oral diseases due to atypical symptoms during the onset of AMI. In combination with a detailed history of inquiry, to observe the dynamic evolution of electrocardiogram and / or myocardial enzyme diagnoses, so that patients receive positive and effective treatment, reducing the patient’s clinical mortality. Conclusions Awareness of atypical AMI should be improved. Combined with clinical symptoms, signs, electrocardiogram and myocardial enzymology examination, the misdiagnosis rate of atypical AMI should be reduced and early diagnosis and early treatment should be strived to improve the prognosis of patients.