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目的总结分析慢性肺源性心脏病(CPHD)合并急性心肌梗死(AMI)的临床特点及误诊原因,探讨早期诊断、治疗策略,以降低误诊率和死亡率。方法对误诊的26例CPHD合并AMI患者的临床资料结合文献进行回顾性分析。结果 49例CPHD合并AMI患者中,死亡15例,死亡率30.61%,误诊26例,误诊率53.06%。结论 CPHD合并AMI患者因临床表现不典型,并发症严重,多因认为原发病加重、忽视检查而误诊,误诊率和死亡率均较高。早期诊断、及时有效治疗是降低CPHD合并AMI患者死亡率的关键,对肺心病住院患者常规检测并定期复查18导联心电图、心肌酶、肌钙蛋白有助于及时诊断AMI。
Objective To summarize the clinical features and causes of misdiagnosis of chronic pulmonary heart disease (CPHD) complicated with acute myocardial infarction (AMI) and to explore the early diagnosis and treatment strategies to reduce the misdiagnosis rate and mortality rate. Methods The clinical data of 26 patients with misdiagnosed CPHD and AMI were retrospectively analyzed. Results Among the 49 patients with CPHD complicated with AMI, 15 died, with a mortality rate of 30.61% and 26 patients misdiagnosed with a rate of 53.06%. Conclusions The patients with CPHD complicated with AMI have atypical clinical manifestations and severe complications. Many patients are considered misdiagnosed as misdiagnosis and misdiagnosis and mortality as the primary disease aggravated. Early diagnosis and timely and effective treatment are the key to reduce the mortality of patients with CPHD complicated with AMI. To routinely check in hospitalized patients with pulmonary heart disease and regularly review the 18-lead ECG, myocardial enzymes and troponin are helpful to timely diagnose AMI.