Clinical value of electrocardiogram combined with myocardial enzymogram in evaluating atypical acute myocardial infarction
Objective To analyze the accuracy of clinical diagnosis of atypical acute myocardial infarction(AAMI)by combining electrocardiogram(ECG)and myocardial enzymogram.Methods From June 2019 to December 2021,45 patients with AAMI and 45 patients with AMI diagnosed in the inpatient emergency department of our hospital were selected into this study.38 patients with AAMI were in the AAMI group and 45 patients with AMI were in the AMI group.Clinical symptoms,clinical features of 12-lead ECG,myo-cardial enzyme profiles(CK,CK-MB,LDH and cTnT),and clinical diagnostic accuracy of 12-lead ECG and ECG combined myocar-dial enzyme profiles were recorded and compared between the two groups.Results The painless rate of 45 patients in AAMI group was 20.00％which was higher than that in AMI group(0.00％)(P＜0.05).The proportion of atypical pain was 73.33％which was higher than that of AMI group(0.00％)(P＜0.05).The rate of typical upper abdomen,chest and back pain was 6.67％,which was lower than that of AMI group(100.00％)(P＜0.05).In 45 patients of AAMI group,20.00％had no ST-T segment change and 17.78％had no pathological Q wave combined with T wave upright and ST segment elevation,which were higher than those of AMI group(0.00％and 0.00％,respectively)(P＜0.05).Pathological Q wave combined with T wave inversion and ST segment arch elevation was 62.22％,which was significantly lower than that in AMI group(100.00％)(P＜0.05).The level of CK(327.59±14.73)IU/L,CK-MB(55.95±7.79)IU/L and cTnT(0.45±0.09)µg/L in AAMI group was significantly lower than those of AMI group(465.42±24.15IU/L,98.22±9.43 IU/L,0.72±0.14 μg/L)(P＜0.05).The LDH(435.99±115.42)IU/L levels were significantly higher than those in AMI group(245.55±54.78 IU/L)(P＜0.05).The accuracy rate of ECG diagnosis in 45 patients in AAMI group was 82.22％,which was sig-nificantly lower than that in AMI group(100.00％)(P＜0.05).At the same time,the diagnostic accuracy of ECG combined with myo-cardial enzymogram in AAMI group was 100.00％that was significantly higher than that of ECG(82.22％);The diagnostic accuracy of ECG combined with myocardial enzymogram in AAMI group and AMI group was 100.00％,there was no difference in between two groups(P＞0.05).Conclusion There are significant differences between AMI and AAMI patients in clinical symptoms,ECG clinical characteristics and five myocardial enzymograms,while the accuracy of clinical diagnosis of AAMI by ECG alone is low.ECG com-bined with five myocardial enzymograms can effectively improve the accuracy of diagnosis of AAMI patients.
NETL
NSTL
万方数据
