52例急性心肌梗死的非典型心绞痛临床表现分析

目的　分析急性心肌梗死的非典型心绞痛临床表现 ,探讨减少临床上的延迟诊断时间 ,使非典型心绞痛的急性心肌梗死患者及早明确诊断 ,及时治疗。方法　回顾分析 5 2例未出现明显心绞痛典型表现的急性心肌梗死 (AMI,所有患者均经心电图及血清酶学检查后确诊 )患者临床表现及治疗过程。结果　在未出现明显心绞痛典型表现的AMI病例中 ,以心血管表现如冠心病心绞痛、严重心律失常等最多见 ,胃肠道症状其次 ,再次为呼吸系统表现、神经系统表现等。年龄 <4 5岁者的AMI初诊时不能及时明确诊断的高达 4 7 8%。延迟诊断时间 8～ 132小时 ,平均 6 1小时。结论　对有冠心病家族史、肥胖、酗酒、长期精神紧张者 ,或有出现难以解释之症状者 ,宜尽早做心电图及血清酶学检查并动态观察 ,以便及时发现非典型心绞痛AMI病例 ,早期诊断和治疗 ,减少延迟诊断率及延迟诊断时间。

Analysis of clinical characteristic in 52 acute myocardial infarction patients with of non-typical angina

Objective To analyse the clinical characteristic in 52 acute myocardial infarction patients with of non-typical angina,and explore how to shorten the time of delayed diagnosis in patients with acute myocardial infarction(AMI) who had the clinical characteristic of non-typical angina,and how to get definite diagnosis and betimes treatment in the AMI patients with non-typical angina. Methods To retrospectively analyse the clinical characteristic and the course of treatment in 52 patients with acute myocardial infarction,all the patients were diagnosed by electrocardiogram (ECG) and blood serum enzymology test finally. Results The most common clinical symptom were cardiovascular representation such coronary heart disease (CHD),angina,severe arrhythmia in AMI patients with non-typical angina,the following representation were gastroenteritis symptom,the lesser representation were respiration system and nerve system.The delayed diagnosis rate was 47.8% in patients aged<45 years old,the delayed time 8 to 132 hours,average out 61 hours. Conclusion The patients with CHD family history,obesity drunken,nervous strain or difficult to interpretative representation,the ECG and the dynamic blood serum enzymology test must be early examined in order to early diagnose the AMI patients with non-typical angina and give early treatment,reduce the delayed diagnosis rate and shorten the delayed diagnosis time.