不典型症状冠心病临床分析

Coronary heart disease with atypical symptoms:Clinical analysis

对84例(A组)不典型症状冠心病患者进行临床分析,并以同期症状典型者257例(B组)为对照,结果表明:A组老年患者为64.3%;伴有糖尿病,慢性阻塞性肺病及高血压病者分别为51.2%,23.8%和22.6%;22.2%以心源性休克为首发症状;猝死率、误诊率和漏诊率等A组均较B组高(P<0.01)。作者认为,对不典型症状冠心病患者,应加强心电图及酶学监测,以防误诊和漏诊。

Clinical features of the 84 cases of coronary heartdisease with atypical symptoms(group A)were ana-lyzed and compared with those of the 257 cases withtypical symptoms(group B).The result showed thatthe older patients accounted for 64.3%(P<0.01);theaccompanied diseases such as diabetes,chronic ob-structive pulmonary disease and hypertension 51.2%,23.8% and 22.6% respectively(P<0.01).19% of theearly manifestations of atypical coronary heart diseasewere attributed to cardiogenic shock(P<0.01).Therates of sudden death,misdiagnosis and neglecteddiagnosis were high in group A.The authors considerthat,in order to avoid misdiagnosis and neglecteddiagnosis,intensive electrocardiographic and enzy-mological monitoring should be practiced in patientswith coronary heart disease with atypical symptoms.