急性心肌梗死合并急性呼吸窘迫综合征的诊断和治疗

Diagnosis and therapy of acute myocardial infarction complicated with acute respiratory distress syndrome

目的探讨急性心肌梗死（AMI）合并急性呼吸窘迫综合征（ARDS）的临床特点和误诊原因，以提高对其认识和诊断水平。方法结合文献资料回顾性分析3例临床病例。结果2例死亡，1例经溶栓、扩张冠状动脉和BIPAP通气治疗好转。结论AMI合并ARDS虽少见，但确实存在．多数情况下易被误诊为左心衰竭性肺水肿，遇不易鉴别病例需行心导管检查。

Objective To investigate the clinical characteristic and the reasons of misdiagnosisof acute myocardial infarction complicated with acute respiratory distress syndrome,and improve thediagnostic approach. Methods To analyse the clinical data of 3 cases retrospectively. Results Twopatients were dead,one was improved by thrombolysis, artery dilation, BiPAP respirator ventilation.Conclusion Although AMI with ARDS is rare.it does exist. It is usually were misdiagnosed as pul-monary edema with left heart failure. Therefore,when differentiative diagnosis is hard to make, thecardiac catherization should be carried.