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目的探讨不典型急性心肌梗死的临床特征。方法分析2006年2月至2009年1月55例老年人不典型心肌梗死的临床资料。结果55例患者经治疗后好转49例,死亡6例。死于心力衰竭3例,心源性休克1例,心脏骤停1例,心室颤动1例。经随访15例合并糖尿病患者3例出现再梗死。结论临床医师应全面检查,对突发不明原因的上腹痛、颈肩背痛、心衰、休克、脑循环障碍等表现而来诊的患者,尤其是高血压病、冠心病、糖尿病、高脂血症等老年患者,须及时动态观察其心电图和心肌酶的变化,应警惕存在不典型AMI的可能,避免误诊。
Objective To investigate the clinical features of atypical acute myocardial infarction. Methods The clinical data of 55 elderly patients with atypical myocardial infarction from February 2006 to January 2009 were analyzed. Results 55 patients improved after treatment in 49 cases, 6 patients died. 3 died of heart failure, 1 cardiogenic shock, cardiac arrest in 1 case and ventricular fibrillation in 1 case. After follow-up of 15 patients with diabetes mellitus in 3 cases of recurrent infarction. Conclusion Clinicians should conduct a comprehensive examination of patients with unexplained upper abdominal pain, neck and shoulder back pain, heart failure, shock and cerebral circulation disorders, especially those with hypertension, coronary heart disease, diabetes, hyperlipidemia Elderly patients with blood disease, to be dynamic and timely observation of changes in ECG and myocardial enzymes, should be alert to the possibility of atypical AMI, to avoid misdiagnosis.