【摘要】 目的分析216例非ST段抬高心肌梗死(NSTEMI)的临床特点。方法采用回顾性分析方法,将786例急性心肌梗死连续病例分为NSTEMI组(216例)及ST段抬高心肌梗死(STEMI)组(570例),比较两组间的临床特点。结果两组比较:(1)STEMI患者数明显多于NSTEMI患者(P<0.01),比率是2.6∶1。(2)老年患者(≥65岁)、无胸痛、原发性高血压、2型糖尿病、脂质代谢紊乱、左主干冠脉病变患者、漏诊在NSTEMI组显著高于STEMI组(P<0.05,P<0.01)。(3)CTnT≥3.0ng/ml、接受冠脉造影检查、行经皮冠脉介入治疗或冠脉旁路移植治疗、LVEF≤55%、室壁瘤(30d)患者在STEMI组显著高于NSTEMI组(P<0.05,P<0.01)。(4)吸烟、冠脉无明显病变、单支至三支病变、急性左心衰竭、心源性休克、室速/室颤、Ⅱ~Ⅲ度AVB及死亡两组间无统计学差异(均P>0.05)。(5)多元逐步回归分析显示恶性心律失常及年龄≥70岁分别是影响NSTEMI死亡的重要因素。结论NSTEMI患者年龄大、危险因素多、左主干冠脉病变多,接受规范治疗少,并发症及死亡率与STEMI患者相似,因此NSTEMI是不可忽视的预后不良的严重疾病。不典型的胸痛及心电图改变容易漏误诊。更多还原

【Abstract】 Objective To analyse the clinical characteristics of 216 patients with non-ST segment elevation myocardial infarction (NSTEMI).Methods A retrospective analysis was performed.786 AMI patients during the same period grouped into STEMI group(570 patients) and NSTEMI group(216 patients).Clinical characteristics in two groups were compared.Results STEMI and NSTEMI patients compared in same time frame revealed:(1)less admitted number of NSTEMI patients.(2) More number of elderly patients,with no chest pain,type 2 DM,hypertension,dyslipidemia,CA disease and loss diagnose in NSTEMI patients.(3) The number of CTnT≥3.0 ng/ml,patients undergone CAG,PCI and CABG treatment,LVEF≤55 and the number of aneurysm (30 days) were less significantly in NSTEMI patients.(4)There exist no significant differences in smokers,less than 50 stenosis in any vessel,one -3 vessel disease,acute left ventricle heart failure,cardiogenic shock,serios arrhythmia( ventricular tachycardia,ventricular fibrillation,Ⅱ-Ⅲ° AV block),deaths.(5) The mulltivariate Logistic regression analysis showed that death in NSTEMI was directly influenced by malignant arrhythmias and age≥70 years.Conclusions Patients with NSTEMI were older,had more risk factors and presence more serious vessel disease,less number of patients could receive standard treatment.Complications and mortality were similar to STEMI.Thus,NSTEMI is a serious disease with poor prognosis.NSTEMI patients may present with atypical chest pain,atypical ECG changes,so are easily loss diagnosed.更多还原