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在急性心肌梗死中,穿壁性心肌梗死(简称TMI)较易诊断;而非穿壁性心肌梗死(简称NTMI)的诊断尚未十分明确,且各家意见不一。为此,仅就所见国内外文献对NTMI有关问题的探讨综述如下: 一、概况按心肌梗死累及心肌程度,分穿壁性与非穿壁性两类。TMI指自心内膜到心外膜1/2以上室壁梗死;NTMI包括心内膜下1/2～1/4厚度的心肌梗死(也称心内膜下心肌梗死,简称SEI),与壁内心肌梗死。文献报道的NTMI,多指SEI或仅有心电图ST—T改变的心肌梗死。 1930年Whitten等首先在心肌梗死病理标本中发现4例SEI。1933年Wilson则提出以心电图进行区别:有病理性Q波者为TMI;
In acute myocardial infarction, the diagnosis of transmural myocardial infarction (referred to as TMI) easier to diagnose; rather than the diagnosis of transmyocardial infarction (NTMI) is not yet very clear, and different opinions. To this end, only to see the domestic and foreign literature on the NTMI-related issues are summarized as follows: First, the overview of myocardial infarction involving the degree of myocardial infarction, divided into two types of wall and non-transmural. TMI refers to the endocardium from the endocardium to the epicardial wall infarction more than 1/2; NTMI, including subendocardial 1/2 ~ 1/4 thickness myocardial infarction (also known as subendocardial myocardial infarction, referred to as SEI) Myocardial infarction. Reported in the literature of NTMI, mostly refers to SEI or ECG-only ST-T changes in myocardial infarction. In 1930, Whitten et al first found four cases of SEI in myocardial infarction pathological specimens. Wilson proposed in 1933 to make the difference between ECG: pathological Q wave TMI;