首诊时心电图正常的不稳定性心绞痛诊治及预后分析

Clinical Analysis of Diagnosis and Treatment and Prognosis of Unstable Angina with Normal ECG during First Visit

目的:提高对首诊心电图正常时不稳定性心绞痛的认识水平。方法:对132例不稳定性心绞痛患者按就诊时检测的心电图结果分为心电图(ECG)正常组(n=40)和ECG缺血组(n=92),将两组诊断、治疗情况及预后进行比较分析。结果:ECG正常组首诊误诊15例(占38%),其中5例发生心肌梗死;治疗失当13例(占52%),其中4例发生心肌梗死。ECG缺血组首诊即得到正确诊断及治疗,有2例发生心肌梗死。两组分项比较差异显著(P<0.05)。结论:心电图正常时不稳定性心绞痛易延误诊治,首诊诊治不当易导致不良预后。

Objective：To elevate the knowledge ot unstable angma （UA） with normal ECG during the first visit. Methods ：132 cases with UA were divided into normal ECG group （n=40） and ischemia ECG group （n= 92） according to ECG performed in diagnosis. The patients in both groups were observed for comparison of diagnosis and treatment and prognosis. Results：In normal ECG group ,during the first visit, 15 cases （38%） were diagnosed incorrectly and 5 cases developed into myocardial infarction,and 13 cases （52%） were treated unreasonably and 4 cases developed into myocardial infarction. In ischemia ECG group,all cases were diagnosed correctly and treated reasonably,and 2 cases developed into myocardial infarction. There were significant difference in the above index between normal and ischemia ECG group. Conclusion：UA with normal ECG may be misdiagnosed and treated unreasonably. The patient misdiagnosed and treated unreasonably during the first visit. It would have a poor prognosis.