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目的探讨消化道大出血合并急性心肌梗死的机制和临床特点。方法 2003年11月—2009年11月分析利辛县人民医院收治消化道大出血并急性心肌梗死20例患者的临床特点、心电图改变、血清心肌酶学测定结果。结果消化道大出血并急性心肌梗死时心电图可示心肌梗死发生的部位及性质,心肌酶谱均升高,病死率高达30%。结论消化道大出血并急性心肌梗死其发病机制与冠状动脉灌流量减少、血管平滑肌收缩、冠状动脉痉挛、狭窄有关。并容易认为由消化系统原发病所致,从而被忽视。为此应注意动态观察其心电图、血清心肌酶学等的变化。
Objective To investigate the mechanism and clinical features of gastrointestinal bleeding combined with acute myocardial infarction. Methods From November 2003 to November 2009, the clinical features, electrocardiogram changes and serum myocardial enzymology results of 20 patients with gastrointestinal hemorrhage and acute myocardial infarction admitted to Lixin County People’s Hospital were analyzed. Results of gastrointestinal bleeding and acute myocardial infarction electrocardiogram can show the location and nature of myocardial infarction, myocardial enzymes were increased, the mortality rate as high as 30%. Conclusions The pathogenesis of gastrointestinal hemorrhage and acute myocardial infarction is related to the decrease of coronary perfusion, contraction of vascular smooth muscle, coronary spasm and stenosis. And easily thought to be caused by the original disease of the digestive system, which is ignored. This should be noted that its dynamic observation of ECG, serum enzymes and other changes in the heart.