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1 病例报告 例1 男,65岁。因发作性心前区疼痛6月余,加重3d入院。每次发作持续数分钟至数小时,晚上发作较多,严重时有心慌胸闷、口唇发绀及出汗,与劳力无关。既往无嗳气、反酸及上腹疼痛。查体:BP 16/9 kPa,心肺(-),腹软,无压痛,未扪及包块,肝脾(-)。辅助检查:血清甘油三脂2.1mmol/L,血清胆固醇5.3mmol/L。发作时心电图检查:①窦性心动过缓;②V_1-V_5 ST段抬高0.2-0.4mV,T波倒置。内镜检查:十二指肠球部粘膜充血水肿。并有0.4cm×0.5cm溃疡。肝胆脾B超检查结果正常。入院后按心绞痛给予心痛定等治疗无效,后按十二指肠溃疡给予甲氰咪呱等治疗,次日胸痛程度减轻,发作次数减少,2周后消失。随访6个月无发作,内镜复查溃疡已愈合。 例2 男。72岁。因发作性心前区疼痛1周入院。每次发作持续数分钟至30min不等,以白天为甚,伴有心慌
1 case report 1 male, 65 years old. Due to episodes of pre-cardiac pain more than 6 months, increased 3d admission. Each episode lasted for several minutes to several hours, more episodes at night, severe palpitation chest tightness, cyanosis and sweating lips, and labor unrelated. Past no trouble, acid reflux and abdominal pain. Physical examination: BP 16/9 kPa, cardiopulmonary (-), abdominal soft, no tenderness, no palpable mass, liver and spleen (-). Auxiliary examination: serum triglyceride 2.1mmol / L, serum cholesterol 5.3mmol / L. Attack ECG: ① sinus bradycardia; ② V_1-V_5 ST segment elevation 0.2-0.4mV, T wave inversion. Endoscopy: duodenal mucosal congestion and edema. And 0.4cm × 0.5cm ulcer. Liver and gallbladder B-ultrasound results were normal. After admission, according to angina pectoris and other treatment given ineffective, followed by duodenal ulcer given cimetidine and other treatment, reduce the extent of chest pain the day after, reduce the number of seizures, disappeared after 2 weeks. Follow-up 6 months without seizure, endoscopic examination of ulcers healed. Example 2 male. 72 years old. Because of episodes of pre-cardiac pain 1 week admission. Each attack lasted several minutes to 30min ranging from day to day, accompanied by palpitation