不同指标诊断心肌梗死后心包炎的差异

目的　观察不同指标对诊断梗死后心包炎发生率的差异以及溶栓与 PTCA对梗死后心包炎发生率的影响。方法　 1 60例急性心肌梗死病人分为常规药物治疗组 75例、溶栓组 5 2例、 PTCA组 3 3例。于梗死后一周内每日常规检查病人且每 1 -2日记录心电图一次 ,部分常规药物治疗及溶栓的病人于梗死后 5 -7天行心脏超声检查。结果　以心包摩擦音、胸膜炎样胸痛、典型心包炎心电图、心电图不典型 T波演变、心包积液作为诊断标准 :梗塞后心包炎发生率在常规组分别为 8%、 2 9.3 %、 1 .3 %、 3 2 %、 2 0 % ;在溶栓组分别为 3 .8%、 1 5 .3 %、 0 %、 2 3 %、 1 7% ;在 PTCA组分别为 0 %、 6.7%、 0 %、 1 0 %。结论　不同指标诊断梗死后心包炎的发生率明显不同 ,其中以心电图不典型 T波改变最高。溶栓与 PTCA治疗可明显降低梗死后心包炎的发生率。

The Effect of Definition on Incidence of Postinfarction Pericarditis

ObjectiveTo compare the difference of incidence of postinfarction pericarditis according to different definition and investigate the effect of thrombolysis and percutaneous coronary angioplasty (PTCA) on the incidence of postinfarction pericarditis.Methods 160 cases suffering from acute myocardial infarction were divided into common theraputic group (75 cases),thrombolytic group (52 cases),and PTCA group (33 cases).Patients were examined every day during the first week after acute myocardial infarction,12 or more leads electrocardiogram were recorded every one or two days.Some of the common theraputic group and thrombolytic group patients were given echocardiographic examination on the 5 th to 7 th day after acute myocardial infarction.Results The incidence of postinfarction pericarditis according to pericarditis friction rub,pleuritic chest pain,typical electrocardiographic alternation in pericarditis,atypical evolution of T wave and pericardial effution is 8%,29.3%,1.3%,32%,and 20% in common theraputic group,3.8%,15.3%,0%,17% and 23% in thrombolytic group and 0%,6.7%,0% and 10% in PTCA group respectively.Conclusions Different defenition resulted in different incidence of postinfarction pericarditis greatly.The incidence of postinfarction pericarditis according to atypical evolution of T wave is the heigest.Thrombolysis and PTCA decreased the incidence of postinfarction pericarditis.