摘要
目的 探讨痛性心肌梗死 (CPMI)和无痛性心肌梗死 (NCPMI)患者的临床特征。方法 将 43 6例AMI患者根据发病前有无胸痛主诉分成无胸痛组 (NCPMI组 ) 14 1例和有胸痛组(CPMI组 ) 2 95例。结果 (1)NCPMI组发病年龄较大 [(70 .2 4± 9.82 )岁比 (62 .3 1± 8.3 5 )岁 ,P <0 .0 1] ,女性占的比例较大 (4 4 .68%比 3 2 .3 0 % ,P <0 .0 1) ,伴有糖尿病 (DM )者较多 (3 4.75 %比2 0 .3 4% ,P <0 .0 0 1) ,既往有心功能不全史较多 (2 3 .40 %比 10 .85 % ,P <0 .0 0 1) ;(2 )NCPMI组来院诊治时间晚 [(7.95± 2 .43 )h比 (5 .3 1± 1.2 2 )h ,P <0 .0 0 1] ,接受静脉溶栓治疗者较少 (2 5 .5 3 %比 5 7.2 9% ,P <0 .0 0 1) ,梗塞相关血管再通率低 (3 5 .46%比 47.46% ,P <0 .0 5 ) ,住院病死率较高(19.15 %比 9.49% ,P <0 .0 1)。结论 急性心肌梗死患者发病前不伴有胸痛症状者预后较有胸痛症状者差。
Objective To observe the clinical characteristics of patients with acute myocardial infarction associated with and without chest pain.Methods A total of 436 patients with confirmed MI enrolled March 1996 to March 2001 in coronary care unit (CCU) at our hospital.The patients with AMI were divided into two groups, NCPMI group(without chest pain) and CPMI group(with chest pain).Results 1.The mean age of NCPMI group was older than that of CPMI group(70.24±9.82 yrs vs 62.31 ±8.35 yrs, P <0.001). There was higher proportion of women (44.68% vs 32.30% ,P <0.05)and patients with diabetes mellitus(34.75% vs 20.34%, P <0.001) or prior heart failure(23.40% vs10.85%, P <0.001)in NCPMI group than that in CPMI group. 2.MI patients without chest pain had a longer delay before hospital presentation(7.95±2.43 h vs 5.31±1.22 h, P <0.001), and were less likely to receive thrombolysis therapy (25.53% vs 47.46%, P <0.001).The reperfusion rate of infarct related artery (IRA) in CPMI group was significantly higher than that in NCPMI group( 35.46% VS 47.46%, P <0.05).MI patient without chest pain had 19.15% in hospital mortality rate compared with 9.49% among patients with chest pain( P <0.05).Conclusions MI patients without chest pain had worse prognosis than those with chest pain.
出处
《临床内科杂志》
CAS
北大核心
2002年第4期268-270,共3页
Journal of Clinical Internal Medicine
