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目的研究心电图始终处于正常范围的急性心肌梗死病例冠状动脉造影和酶学检查的特点,以减少急性心肌梗死的漏诊。方法选择2005年3月至2011年3月临床确诊为急性心肌梗死的病例574例,按照是否有ST段抬高分为ST段抬高组和心电图正常组,分析比较两组冠状动脉造影和酶学检查的特点。结果心电图正常组81例,ST段抬高组493例,两组冠状动脉造影比较,病变血管在左主干(LM)、右冠状动脉(RCA)有显著差异(P<0.05,P<0.01);酶学检查肌钙蛋白(cTnI)、肌酸激酶(CK)有差异(P<0.05)。结论心电图始终处在正常范围的急性心肌梗死,其特点是冠状动脉造影检查呈多支病变,不易发生左主干梗死,酶学检查数值升高的程度低于ST段抬高型急性心肌梗死。
Objective To study the characteristics of coronary angiography and enzymology in patients with acute myocardial infarction whose electrocardiogram is always in the normal range to reduce the missed diagnosis of acute myocardial infarction. Methods From March 2005 to March 2011, 574 patients with clinically diagnosed acute myocardial infarction were enrolled in this study. According to the presence or absence of ST-segment elevation, they were divided into ST-segment elevation group and normal ECG group. The coronary angiography and enzyme School inspection features. Results There were 81 patients with normal electrocardiogram and 493 patients with ST segment elevation. There was significant difference between the two groups in coronary angiography (LM and RCA) (P <0.05, P <0.01). Enzymatic examination of troponin (cTnI), creatine kinase (CK) were different (P <0.05). Conclusion ECG is always in the normal range of acute myocardial infarction, which is characterized by coronary angiography showed multiple lesions, less prone to left main infarction, elevated levels of enzymatic examination was lower than ST-segment elevation acute myocardial infarction.