无胸痛急性冠脉综合征32例临床分析

目的 分析32例无胸痛急性冠脉综合征(ACS)病人，强化对无胸痛ACS的认识，提高早期诊断率，为早期强化治疗奠定基础。方法 将275例病人按是否有典型胸痛分为无痛组(32例)、有痛组(243例)；从年龄、心血管病危险因素、血脂、入院时主要症状及主要并发症、ACS的临床诊断分类、确诊时间、治疗情况、死亡率等方面，比较分析两组病人的临床资料。结果 无痛组女性病人明显增加；ACS发生率随着年龄增长而增高；伴有糖尿病、高血压及心衰者更易发生无胸痛ACS；无胸痛ACS缺乏典型心前区疼痛，常伴有心律失常、心衰、心源性休克、脑血管病等并发症；无痛组病人早期确诊率明显低于有痛组。结论 无胸痛ACS无典型症状，容易误诊及延误治疗，进而对预后产生不良影响。

Clinical analysis of 32 acute coronary syndrome cases without thoracalgia

Objectives To study the clinical indexes, and improve early diagnosis and treatment of acute coronary syndromes(ACS) by analysis of 32 ACS patients.Methods 275 patients were divided into no-pain group (n=32) and pain group (n=243) according to symptom. The clinical indexes including age, risk factors, lipidemia, chief symptoms and complications, clinical classification, time of diagnosis,treatments, mortalities, etc, were analysed.Results Prevalence of female ACS patients significantly increased in no-pain group. The occurrence of ACS was increased with age. The patients who had diabetes mellitus or hypertension or heart failure were more likely to suffer from no-pain ACS. There was no typical chest pain in no-pain ACS patients, and these patients had complications such as cardiac arrhythmias, heart failure, cardiogenic shock, cerebrovascular disease. The early diagnosis rate of pain group was higher than the no-pain group.Conclusion No-pain ACS patients had no typical symptoms, so it was difficult to make a correct diagnosis.