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目的：分析无痛性ST段抬高型心肌梗死患者的危险因素，从而增强急诊内科对于无痛性ST段抬高型心肌梗死患者的辨别能力。方法通过回顾性研究，对2010年~2014年于我院急诊内科被诊断为ST段抬高型心肌梗死患者的临床特征进行分析，并对有典型胸痛的心肌梗死患者与无痛性心肌梗死患者的临床特征进行比较。结果糖尿病史、中风史和高龄是无痛性ST段抬高型心肌梗死患者的主要危险因素，OR值分别是23.10、7.03、4.44。结论糖尿病史、中风史和高龄患者更易于发生无痛性ST段抬高型心肌梗死。“,”Objective To identify factors associated with ST-segment myocardial infarction (STEMI) patients who experienced no chest pain, and to improve recognition of STEMI patients without presentation of chest pain in the emergency room (ER). Methods A retrospective study was conducted in ER of the Affiliated Hospital of Nantong University from 2010 to 2014. Clinical characteristics and presentations were recorded in patients diagnosed with STEMI in the ER. Patients with and without chest pain were compared according to clinical features. Results Among the 228 STEMI patients, 14.04%of patients had no chest pain presentation in the ER. Syncope, epigastric pain, and dyspnea accounted for more than 70% of symptoms in STEMI patients without chest pain. Diabetes mellitus (DM), cerebrovascular accident (CVA), and old age were risk factors for STEMI patients without chest pain. Conclusions DM, CVA, and elderly patients are more likely to be without chest pain when STEMI occurred.