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目的分析探讨不典型急性心肌梗死的临床特点,为不典型急性心肌梗死患者的诊断提供理论支持和科学指导。方法回顾性分析100例不典型急性心肌梗死患者的临床资料,总结临床特点。结果合并高血压病20例,糖尿病25例,脑梗死18例,高脂血症10例,不典型急性心肌梗死男性发病率大于女性。临床首诊为急性心肌梗死40例(40%);消化系统疾病15例(15%);神经系统疾病17例(17%);咽炎3例(3%);牙痛5例(5%);呼吸系统疾病10例(10%);颈椎病6例(6%);其他部位疾病4例(4%)。存在典型急性心肌梗死心电图表现89例(89%)。发病24 h以上心肌酶明显升高大于正常值2倍以上100例(100%)。给予积极治疗后,治愈出院91例(91%),死亡9例(9%)。结论对于老年男性、糖尿病、脑血管病出现一些临床异常现象,需注意是否为急性心肌梗死的可能,并及时进行相关辅助检查以取得正确诊断。明确不典型急性心肌梗死的临床特点及诊治方法 ,可提高对该病的临床判断能力。
Objective To analyze the clinical features of atypical acute myocardial infarction and provide theoretical support and scientific guidance for the diagnosis of atypical acute myocardial infarction. Methods The clinical data of 100 patients with atypical acute myocardial infarction were retrospectively analyzed, and the clinical features were summarized. Results 20 cases of hypertension, 25 cases of diabetes, 18 cases of cerebral infarction, hyperlipidemia in 10 cases, atypical acute myocardial infarction in men than in women. The first clinical diagnosis was 40 cases of acute myocardial infarction (40%), 15 cases of digestive system diseases (15%), 17 cases of nervous system diseases (17%), 3 cases of pharyngitis (3%), 5 cases of toothache (5% Respiratory diseases in 10 cases (10%); cervical spondylosis in 6 cases (6%); other parts of the disease in 4 cases (4%). There are 89 cases (89%) of typical acute myocardial infarction electrocardiogram. The incidence of myocardial enzymes above 24 h was significantly higher than normal 2 times more than 100 cases (100%). Given active treatment, 91 patients were discharged (91%) and 9 died (9%). Conclusion In elderly men, there are some clinical abnormalities in diabetes and cerebrovascular disease. It is necessary to pay attention to the possibility of acute myocardial infarction and to timely carry out the relevant auxiliary examination to obtain the correct diagnosis. Atypical atypical acute myocardial infarction clinical features and diagnosis and treatment methods, can improve the clinical judgment of the disease.