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目的运用循证医学的方法检索和评价糖尿病肌梗死的最佳诊断手段。方法2006年3月对四川大学华西医院应用计算机检索Cochrane图书馆(2005年4月)、Embase(1974年1月至2005年11月)、Med-line(1966年至2005年11月)和CNKI数据库(1949年至2005年11月),查找关于糖尿病肌梗死诊断的指南、系统评价、随机对照试验、临床对照试验和个案报道,并对所获证据进行质量评价。结果目前的临床证据表明,对疑诊糖尿病肌梗死的患者,首先应选择彩色多普勒检查来排除一些常见疾病;行CT检查的患者,100%未发现明显异常;67例行普通MRI的患者中,100%的患者表现为典型的糖尿病肌梗死;进行了肌肉活检或针刺活检的所有患者均未发生任何并发症。结论糖尿病肌梗死的诊断是基于临床表现和MRI检查的综合诊断。
Objective To use the method of evidence-based medicine to search and evaluate the best diagnostic method of diabetic myocardial infarction. Methods In March 2006, the Cochrane Library (April 2005), Embase (January 1974 to November 2005), Med-line (1966 to November 2005) and CNKI Database (from 1949 to November 2005) to find guidelines, systematic reviews, randomized controlled trials, controlled trials and case reports on the diagnosis of diabetic myocardial infarction, and to evaluate the quality of the evidence obtained. Results The current clinical evidence shows that color Doppler imaging should be used to exclude some common diseases in patients with suspected myocardial infarction. No significant abnormalities were found in 100% of the patients underwent CT examination. 67 patients with normal MRI , 100% of patients showed typical diabetic MI; all patients who underwent muscle biopsy or needle biopsy did not experience any complications. Conclusion The diagnosis of diabetic myocardial infarction is based on the comprehensive diagnosis of clinical manifestations and MRI examination.