急性主动脉夹层合并急性心肌梗死临床分析

目的探讨急性主动脉夹层（acute aortic dissection，AAD）合并急性心肌梗死（acute myocardial infarction，AMI）患者的临床特点及治疗方法。方法回顾性分析12例AAD合并AMI患者的临床资料。结果本组患者均以胸痛为首发症状，确诊AAD前均误诊为AMI；7例行超声心动图确诊，5例未见异常；心电图显示急性下壁心肌梗死7例，前壁心肌梗死2例，非ST段抬高型心肌梗死3例；确诊后行溶栓治疗3例，手术治疗9例，死亡3例；术后存活者随访期间生活质量明显改善，无主要不良心脏事件发生。结论AAD合并AMI误诊率高，预后差；手术是治疗AAD合并AMI的有效方法。

Clinical analysis of acute aortic dissection complicated with acute myocardial infarction

Objective To explore the d~meat features ~ acute myocardial infarction （AMI）. Methods Twelve patients of AAD complicated with AMI were retrospectively analyzed. Results The initial symptom of 12 patients was chest pain, which was misdiagnosed as AMI. Ultrasou：~d cardiography revealed AAD complicated with AMI in 7 patients and normal in the other 5 patients. The electrocardiography showed inferior myocardial infarction in 7 patients, anterior myocardial infarction in 2 patients and non-ST-segmer~t elevation myocardial ~nfaretion in 3 patients. Three patients ut~derwent thrombolytic treatment, and 9 were performed operation after diagnosis. Three patients died. The quality of life was greatly improved and no major adverse cardiac events occurred. Conclusions The misdiagnosis rate is high and the prognosis is poor. Operation is an effective method for AAD complicated with AMI.