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目的探讨消化道出血合并急性心肌梗死的机制及其临床特点。方法1997-07-2004-05回顾性分析沈阳市第五人民医院消化道出血合并急性心肌梗死16例患者的临床特点、心电图改变、血清心肌酶学及肌钙蛋白的测定结果。结果消化道出血与急性心肌梗死均为临床重危症,消化道出血合并急性心肌梗死时。病死率明显升高,其发病机制与冠状动脉灌流量减少、血管平滑肌收缩,冠状动脉痉挛、狭窄有关,消化道出血时其急性心肌梗死的表现易被认为由消化系统原发病所致,从而被忽视。结论应注意动态观察其心电图、血清心肌酶学、肌钙蛋白的变化。
Objective To investigate the mechanism and clinical features of gastrointestinal bleeding combined with acute myocardial infarction. Methods A retrospective analysis of clinical features, electrocardiogram changes, serum myocardial enzymes and troponin in 16 patients with gastrointestinal bleeding complicated by acute myocardial infarction in the Fifth People ’s Hospital of Shenyang City from July 1997 to April 2004 was performed. The results of gastrointestinal bleeding and acute myocardial infarction are clinical critically ill, gastrointestinal bleeding with acute myocardial infarction. Mortality significantly increased its pathogenesis and coronary perfusion, vascular smooth muscle contraction, coronary spasm, stenosis, gastrointestinal bleeding when its acute myocardial infarction performance easily considered to be caused by the primary disease of the digestive system Neglected. Conclusion should pay attention to dynamic observation of ECG, serum myocardial enzymes, troponin changes.