摘要
收集2008年10月—2019年12月就诊于北京安贞医院冠心病中心明确诊断为急性主动脉夹层合并急性心肌梗死患者共68例,分析临床表现、实验室检查、诊疗策略及预后等。68例中,男57例,女11例;Stanford分型:A型67例,B型1例;合并ST段抬高型心肌梗死53例,非ST段抬高型心肌梗死15例,首发表现多为胸痛或胸背痛。68例患者中,外科手术治疗50例,经皮冠状动脉腔内血管成形术1例,其余17例患者未接受手术治疗;住院好转患者44例,死亡24例。急性主动脉夹层合并急性心肌梗死患者起病急,病情危重,且其首发症状与急性心肌梗死多有相似之处,极易造成漏诊误诊,因此高度的怀疑和警觉是确定诊断和获得最佳临床结果的关键。
A total of 68 patients with acute aortic dissection complicated with acute myocardial infarction diagnosed in the Coronary Heart Disease Center of Beijing Anzhen Hospital from October 2008 to December 2019 were collected.The clinical manifestation,laboratory examination,diagnosis and treatment strategy and prognosis were analyzed.There were 57 males and 11 females in 68 cases.Stanford classification:67 cases of type A and 1 case of type B.There were 53 cases of ST segment elevation myocardial infarction and 15 cases of non ST segment elevation myocardial infarction.The first manifestation was chest pain or chest and back pain.Among the 68 patients,50 underwent surgical treatment,1 underwent percutaneous transluminal coronary angioplasty,and the other 17 patients did not receive surgical treatment.44 inpatients improved and 24 died.Patients with acute aortic dissection complicated with acute myocardial infarction have acute onset and critical condition,and their initial symptoms are much similar to acute myocardial infarction,which is easy to cause missed diagnosis and misdiagnosis.Therefore,high suspicion and vigilance are the key to determine the diagnosis and obtain the best clinical results.
作者
王鸽
缪黄泰
周璨
赵冠棋
聂绍平
Wang Ge;Miao Huangtai;Zhou Can;Zhao Guanqi;Nie Shaoping(Center for Cononary Artery Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China)
出处
《疑难病杂志》
CAS
2021年第9期905-908,共4页
Chinese Journal of Difficult and Complicated Cases
基金
国家重点研发计划项目(2020YFC2004800)
北京市医院管理局登峰计划(DFL20180601)
心血管精准医学北京重点实验室(PXM2018_014226_000013)
光电测试技术北京市重点实验室(GDKF2020001)。
关键词
心肌梗死
急性
主动脉夹层
临床特征
Myocardial infraction,acute
Aortic dissection
Cinical features
