【摘要】 目的 探讨无痛性心肌梗死的临床特征。方法 将83例急性心肌梗死(AMI)患者根据有无胸痛而分为无胸痛组35例和胸痛组48例，比较2组的临床特征。结果 无胸痛组发病年龄大(68.6±7.3岁对55.2±4.7岁，P<0.05)，伴有糖尿病者多(62.9%对33.3%，P<0.01)；平均就诊时间晚(18.2±2.3h对6.5±3.0h，P<0.001)；接受静脉溶栓者少(11.43%对66.67%，P<0.001)；IRA再通率低(8.57%对68.75%，P<0.01)；住院5周病死率高(14.29%对6.25%，P<0.01)。结论 无胸痛组患者较胸痛组患者预后差。因此应及早诊断，有效治疗。

    【关键词】 无痛性心肌梗死；临床特征；预后

    Clinical study on 45 cases of painless myocardial infarction

    GAO Wen-mei.

    Shanghai Dahua Hospital,Shanghai 200237,China

    【Abstract】 Objective To investigate the clinical characteristic of painless myocardial infarction. Method 83 cases of patients with acute myocardial infarction were divided into painless group (n=35) and pain group (n=48) based on pain symptom and compared clinical characteristic between them. Result Compared with pain group, patients in the painless group have older age (age: 68.6+/-7.3 vs.55.2+/-4.7,P<0.05) and more of them have concomitant diabetes (62.9% vs.33.3%,P<0.01). In addition, patients in painless group have later time of vist (18.2+/-2.3h vs.6.5+/-3.0h,P<0.001), less vein thrombolysis treatment (11.43% vs.66.67%,P<0.001), less recanalization rate (8.57% vs.68.75%,P<0.01) and less case fatality ratio in 5 weeks of hospitalization (14.29% vs.6.25%,P<0.01).Conclusion The painless group has poorer prognosis compared with the pain group and should receive early diagnosis and effective treatment. ......