Kounis综合征二例误诊临床分析

Clinical Analysis of Misdiagnosis of Kounis Syndrome in 2 Cases

目的 探讨Kounis综合征的临床特点及误诊原因,提高诊治水平。方法 回顾性分析误诊为其他疾病的Kounis综合征2例的临床资料。结果 1例因胸闷、胸痛20min急诊入院,误诊为急性下壁心肌梗死、药物过敏,予抗心肌缺血和抗过敏治疗后病情稍好转;1例因间断胸闷、胸痛、气短3d就诊,误诊为冠心病、不稳定型心绞痛,予抗心肌缺血治疗后病情无明显改善,后加用抗过敏治疗后病情好转。综合病史、医技检查结果,确诊为Kounis综合征Ⅰ型与Kounis综合征Ⅱ型。随访3个月,患者病情均未复发。结论 Kounis综合征缺乏特异性临床表现,加强认识、提高诊治水平是医生尽早确诊、改善预后的关键。

Objective To investigate the clinical features and causes of misdiagnosis of Kounis Syndrome, and to improve diagnosis and treatment of this disease. Methods We conducted a retrospective analysis on the clinical data of 2 cases of Kounis Syndrome which had been misdiagnosed as other diseases. Results One patient sought emergency treatment after suffering chest distress and chest pain for 20 min. This patient was misdiagnosed as acute inferior myocardial infarction and drug allergy. After treatment against myocardial ischemia and antiallergic measures, the patient's condition was improved. The second patient presented with intermittent chest distress, chest pain and shortness of breath for 3 d. This patient was misdiagnosed as coronary heart disease and unstable angina pectoris, which didn't improve after treatment against myocardial ischemia. However, the patient became better after treatment with antiallergic measures. According to medical histories and medical examination results, the first patient was diagnosed as Kounis Syndrome Type Ⅰ, and the second patient was diagnosed as Kounis Syndrome Type Ⅱ. During follow-up visits in three months after the clinical treatment, neither reported recurrence. Conclusion Given lack of specific and obvious clinical manifestations, to deepen the understanding of Kounis syndrome and improve therapeutic ability of physicians is the key to confirming an early diagnosis and improving the prognosis on Kounis syndrome.