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目的探讨以急性左心衰竭为首发表现的急性心肌梗死(AM I)的诊断及冠状动脉造影特征。方法分析我院2000年至2007年304例急性心肌梗死患者,分为急性左心衰竭组(70例),非急性左心衰竭组(234例)进行年龄、心电图、血糖、诊断及冠状动脉造影分析。结果急性左心衰竭组与非急性左心衰竭组比较,心电图典型ST段弓背抬高发生率低,不易及时诊断,多见于老年人、糖尿病或应激性血糖患者,P<0.01,冠状状动脉左主干、3支病变发生率高,P<0.01,差异均有统计学意义。结论急性左心衰竭为首发表现的急性心肌梗死患者,冠状动脉病变更加广泛,左主干发生率高,不易及时诊断,应引起重视。
Objective To investigate the diagnosis of acute myocardial infarction (AMI) presenting with acute left heart failure and the characteristics of coronary angiography. Methods A total of 304 patients with acute myocardial infarction from 2000 to 2007 in our hospital were divided into acute left heart failure group (70 cases) and non-acute left heart failure group (234 cases) for age, electrocardiogram, blood glucose, diagnosis and coronary angiography analysis. Results Compared with non-acute left heart failure group, the incidence of ST elevation in typical ST segment of ECG in acute left heart failure group was less than that in non-acute left heart failure group, which was more difficult to be diagnosed in time. It was more common in elderly, diabetic or stress-induced glucose patients, P <0.01, Artery left main trunk, 3 lesions high incidence, P <0.01, the differences were statistically significant. Conclusions Acute left heart failure is the first manifestation of acute myocardial infarction patients, coronary lesions more extensive, high incidence of left main, not timely diagnosis, should pay attention.