糖尿病合并急性心肌梗死（AMI）的临床特点、误诊原因及对策分析.doc

精品论文 参考文献 糖尿病合并急性心肌梗死（AMI）的临床特点、误诊原因及对策分析 湖南省沅江市人民医院 湖南沅江 413100 【摘 要】目的：研究糖尿病合并急性心肌梗死（AMI）的临床特点、误诊原因及对策分析。方法：2009年5月至2013年5月在我院确诊为糖尿病合并AMI的患者和确诊为非糖尿病AMI患者共156例，平均分为2组。探讨两组患者的临床特点、误诊原因以及对策分析。结果：A组患者的GLU、TG、HDL的浓度均明显高于对照组B（Plt;0.05）；A组患者的主要临床症状表现为压榨性胸痛、呼吸困难、胃肠道反应、上腹痛，其发生率分别为41.0%、23.1%、12.8%、14.1%，均明显高于B组（Plt;0.05），同时A组的弥漫性冠状动脉、重度冠状动脉狭窄的发生率分别为52.6%、50.0%，与B组相比存在显著性差异（Plt;0.05），而且B组出现典型心肌梗死时间段为6：00-13：59，发病率为53.8%，与A组该时间段发病率显著性差异（Plt;0.05）；A组患者的误诊率、死亡率、治疗后再狭窄率以及各并发症的发生率，显著高于B组（Plt;0.05）结论：糖尿病合并AMI临床特点存在隐匿性，误诊率高，临床上应该对于可疑病例进行密切观察，治疗上采用糖尿病与心肌梗死治疗方案相结合的策略。 【关键词】糖尿病合并急性心肌梗死（AMI）；临床特点；误诊原因；对策分析 [Abstract] Objective：to study the clinical features，misdiagnosis causes and countermeasures of acute myocardial infarction（AMI）with diabetes.Methods：From May 2009 to May 2013，there were 156 patients who were diagnosed with either AMI with diabetes or AMI without diabetes.They were equally divided into 2 groups.Discussions were made on the two groups in terms of their clinical features，misdiagnosis causes and countermeasures.Results：The amounts of GLU，TG，HDL concentrations of group A were significantly higher than those of control group，namely，group B（Plt;0.05）.As for patients in group A，the main clinical symptoms were pressing chest pain，difficult breathing，gastrointestinal reaction，and epigastric pain，of which the occurence rates were respectively 41%，23.1%，12.8%，14.1%，higher than those of group B（Plt;0.05）.In the meantime the occurrence rates of diffusing coronary artery and heavy arteriarctia were respectively 52.6%，50%，which were of significant differences when compared with group B（Plt;0.05）；and group B had the time of typical myocardial infarction -6：00-13：59.The occurrence rate of group B was 53.8%，was much higher than the correspounding time of group A（Plt;0.05）.Moreover，the misdiagnosis rate，mortality，rates of restenosis after treatment as well as the incidence of complications were significantly higher than those of group B（Plt;0.05）.Conclusions：Since AMI with diabetes