摘要
目的:对比分析无胸痛急性心肌梗死(NCPAM I)和有胸痛急性心肌梗死(CPAM I)患者的临床特征。方法:将1 446例急性心肌梗死(AM I)患者根据发病时有无胸痛主诉分成无胸痛组(NCPM I组,268例)和有胸痛组(CPM I组,1 178例)。结果:NCPM I组比CPM I组发病年龄大[(68.25±9.57)岁比(62.53±8.69)岁,P<0.05],女性占的比例较大(42.9%比30.1%,P<0.001),伴有糖尿病(DM)者较多(38.1%比20.1%,P<0.001),既往有心衰史者较多(28.7%比11.8%,P<0.001);NCPM I组院前延误的时间较长[(7.78±2.74)h比(5.02±1.47)h,P<0.05],接受再灌注治疗者较少(56.3%比74.5%,P<0.001),梗死相关动脉(IRA)再通率较低(41.8%比56.1%,P<0.001),并发心律失常、心力衰竭、心原性休克者较多(P<0.05),住院病死率较高(15.2%比8.3%,P<0.05);而冠心病家族史、烟酒史、高血压史、职业、梗死部位分布、血脂、血尿酸、肝功能差异无统计学意义;肾功能有下降的趋势,但差异无统计学意义。结论:发生急性心肌梗死时无胸痛症状人群比有胸痛症状人群年龄较大,合并症和并发症较多,就诊较晚,再灌注治疗率较低,预后较差。
Objective：To analyze the clinical characteristics of patients with acute myocardial infarction associated with and without chest pain. Methods： A total of 1 446 patients with confirmed AMI were enrolled from Jan. 2000 to Dec. 2005 in this hospital. The patients were divided into two groups, NCPMI group （without chest pain） and CPMI group（ with chest pain）. Results： The average age of NCPMI group was older than that of CPMI group [ （68.25 ± 9.57 ） yrs vs （ 62.53 ± 8.69） yrs, P 〈 0.05 ]. There was higher proportion of women（42.9% vs 30.1%, P 〈 0. 001 ） and patients with diabetes mellitus（38.1% vs 20.1%, P 〈 0. 001 ） and with prior heart failure （28.7% vs 11.8%, P 〈 0. 001 ） in NCPMI group than that in CPMI group; AMI patients without chest pain had a longer delay before hospital presentation[ （7.78 ± 2. 74）h vs （ 5.02 ± 1.47 ） h, P 〈 0.05 ） ] and were less likely to receive reperfusion therapy （ 56.3 % vs 74. 5 %, P 〈 0. 001 ）. The reperfusion rate of infarct-related artery（IRA） in NCPAMI group was significantly lower than that in CPMI group（41.8% vs 56.1%, P 〈 0. 001 ） and the hospital fatality rate in NCPMI group was significantly higher than that in CPMI group （15. 2% vs 8.3 %, P 〈 0. 05）. Conclusion：AMI patients without chest pain have older age, longer delay before presentation at hospital and worse prognosis than those with chest pain.
出处
《军事医学科学院院刊》
CSCD
北大核心
2006年第3期248-249,298,共3页
Bulletin of the Academy of Military Medical Sciences
关键词
急性心肌梗死
胸痛
诊断
预后
acute myocardial infarction
chest pain
diagnosis
prognosis
