|
心肌梗死的临床诊断方法综述
|
Abstract:
心肌梗死是一种严重的心血管疾病,通常是由于冠状动脉狭窄或阻塞引发的,临床上可能导致严重的并发症,如心力衰竭、心律失常和心源性休克等,对人们生命健康带来极大的威胁。因此,早期的诊断和发现对于患者的治愈率和存活率具有相当重大的意义。目前,对于心肌梗死的研究中,许多国内外学者提出了许多切实有效的诊断方法,包括心电图(ECG)、血液生化标志物、心脏超声检查和冠状动脉造影等,并在实际中运用,但诊断方法繁多。为了在实际中更高效便捷地诊断疾病,本文综述了现有研究中多种心肌梗死的临床诊断方法,直观地总结出诊断中的判别指标,为临床应用提供一定的指导建议。
Myocardial infarction is a serious cardiovascular disease, usually triggered by narrowing or blockage of the coronary arteries, which can clinically lead to serious complications such as heart failure, arrhythmias and cardiogenic shock, posing a great threat to people’s life and health. Therefore, early diagnosis and detection are of considerable importance to the cure rate and survival of patients. Currently, in the study of myocardial infarction, many effective diagnostic methods, including electrocardiography (ECG), blood biochemical markers, cardiac ultrasonography and coronary angiography, have been proposed and used in practice by many domestic and international scholars, but the diagnostic methods are numerous. In order to diagnose the disease more efficiently and conveniently in practice, this article reviews a variety of clinical diagnostic methods for myocardial infarction in existing studies, visually summarises the discriminatory indicators in diagnosis, and provides certain guidance suggestions for clinical application.
[1] | Shah, A.H., Puri, R. and Kalra, A. (2019) Management of Cardiogenic Shock Complicating Acute Myocardial Infarction: A Review. Clinical Cardiology, 42, 484-493. https://doi.org/10.1002/clc.23168 |
[2] | 汪雪, 王新新, 纪天亮, 徐彩霞. 血清miR-208对心肌梗死超急性期的诊断价值[J]. 中国实验诊断学, 2022, 26(5): 714-716. |
[3] | Li, P., Li, S.-Y., Liu, M., Ruan, J.-W., Wang, Z.-D. and Xie, W.-C. (2019) Value of the Expression of miR-208, miR-494, miR-499 and miR-1303 in Early Diagnosis of Acute Myocardial Infarction. Life Sciences, 232, Article ID: 116547. https://doi.org/10.1016/j.lfs.2019.116547 |
[4] | 贾亭街, 党军强. 急性心肌梗死患者血清miR-208a检测及其临床意义[J]. 中国医药指南, 2012, 10(35): 423-424.
https://doi.org/10.15912/j.cnki.gocm.2012.35.247 |
[5] | Jiao, D., Arunkumar, N., Zhang, W., Li, B., Zhang, X. and Zhu, G. (2018) Semantic Clustering Fuzzy C Means Spectral Model Based Comparative Analysis of Cardiac Color Ultrasound and Electrocardiogram in Patients with Left Ventricular Heart Failure and Cardiomyopathy. Future Generation Computer Systems, 92, 324-328.
https://doi.org/10.1016/j.future.2018.10.019 |
[6] | 任伟宏, 赵素玲, 李延卿, 等. 乙型肝炎患者血清中HBV cccDNA与HBV DNA、HBsAg和HBeAg定量关系的分析[J]. 检验医学, 2010, 25(6): 438-441. |
[7] | 彭及良, 温秀明, 许瑞环, 等. 乙型肝炎患者HBV-DNA定量检测与HBV血清学标志组合的关系[J]. 中国医药导报, 2010, 7(17): 64-65. |
[8] | 程娇艳. 心脏彩超及心电图对心肌梗死诊断的临床价值分析[J]. 影像研究与医学应用, 2022, 6(20): 179-181. |
[9] | 朱朝燕, 张瑜. 心电图与心脏彩超联合检诊异常Q波[J]. 中国医学工程, 2015, 23(4): 77+79. |
[10] | 热依拉·吐尔迪, 杨毅宁. D-二聚体及纤维蛋白原降解产物在急性ST段抬高型心肌梗死中的研究进展[J]. 医学综述, 2018, 24(8): 1478-1481, 1487. |
[11] | 刘恩, 杜平. 血浆凝血酶原和纤维蛋白原在诊断60岁以下急性心肌梗死中的价值分析[J]. 中国实验诊断学, 2019, 23(5): 853-855. |
[12] | 郭晓杰, 王修楠, 都基刚, 任美英. 纤维蛋白原与血浆凝血酶原在诊断急性心肌梗死中的作用评估[J]. 中国实验诊断学, 2022, 26(8): 1119-1120. |
[13] | 雷芳. 二维斑点追踪超声心动图在评价心肌梗死患者左室重构中的应用价值[J]. 江西医药, 2022, 57(9): 1229-1231. |
[14] | 李爽, 贺鹭. 二维超声斑点追踪成像评估老年急性心肌梗死患者左室心功能的价值[J]. 影像科学与光化学, 2020, 38(3): 550-554. |
[15] | 李俣亭, 章淬. 二维斑点追踪超声心动图技术在心脏外科围术期的临床应用进展[J]. 中国心血管病研究, 2023, 21(2): 120-126. |
[16] | 马新欣, 张跃力, 王曼, 郑东燕, 薛晓培, 朱梦若, 江文君. 自发性高血压大鼠左心室心肌应变与心肌纤维化程度的相关性[J]. 中国医学影像技术, 2017, 33(2): 161-166. |
[17] | 杨锦淑, 刘燕, 浦仕成, 李魁. 心脏超声斑点追踪在急性心肌梗死诊断及分型中的应用价值[J]. 临床医学, 2022, 42(9): 92-94. https://doi.org/10.19528/j.issn.1003-3548.2022.09.033 |
[18] | ?im?ek, A., Turan, ?., ?iftel, M., Kardelen, F., Durmaz, E., ?zdem, S., Ak?urin, G. and Ertu?, H. (2018) Evaluation of Left Ventricular Functions with Two-Dimensional Speckle-Tracking Echocardiography (2D-STE) and N-Terminal Probnp in Diabetic Children. The Turkish Journal of Pediatrics, 60, 633-641.
https://doi.org/10.24953/turkjped.2018.06.003 |
[19] | Ersb?ll, M., Valeur, N., Mogensen, U.M., Andersen, M.J., M?ller, J.E., Hassager, C., S?gaard, P. and K?ber, L. (2012) Relationship between Left Ventricular Longitudinal Deformation and Clinical Heart Failure during Admission for Acute Myocardial Infarction: A Two-Dimensional Speckle-Tracking Study. Journal of the American Society of Echocardiography, 25, 1280-1289. https://doi.org/10.1016/j.echo.2012.09.006 |
[20] | Umnov, I.N., Bobrov, A.L. and Alekhin, M.N. (2020) Contrast Echocardiography with a Quantitative Assessment of Myocardial Perfusion in Patients with Previous Q—Wave Myocardial Infarction. Kardiologiia, 60, 17-23.
https://doi.org/10.18087/cardio.2020.2.n817 |
[21] | 辛晓芬. 彩色多普勒超声心动图检测在急性心肌梗死诊断中的应用分析[J]. 黑龙江中医药, 2021, 50(4): 195-196. |
[22] | 牛婷. 心肌梗死范围超声诊断与心电图诊断价值的分析[J]. 影像研究与医学应用, 2023, 7(2): 191-193. |
[23] | 吴瑶, 成智东. 动态心电图联合超声心动图检查在急性心肌梗死患者预后评估中的应用价值[J]. 现代医用影像学, 2022, 31(10): 1943-1945+1956. |
[24] | 吴丽霞, 亓鸣, 亓智浩. 血清心肌酶谱和BNP与MYO以及cTnⅠ联合检测对急性心梗的诊断价值分析[J]. 当代医学, 2020, 26(8): 167-169. |
[25] | 石淑磊. cTnT(肌钙蛋白)、NT-proBNP(N-端脑钠肽前体)及心肌酶谱联合检测对ACS(急性冠脉综合征)的诊断分析[J]. 中外女性健康研究, 2018(20): 59+115. |
[26] | 刘晓琳, 刘洁. 心肌酶谱联合肌钙蛋白I检测在急性心肌梗死诊断中的价值[J]. 河南医学高等专科学校学报, 2023, 35(2): 180-182. |
[27] | 张丽丽. 心肌酶谱和肌钙蛋白I联合检测对诊断急性心肌梗死的临床应用价值[J]. 中西医结合心血管病电子杂志, 2021, 9(5): 196-198. https://doi.org/10.16282/j.cnki.cn11-9336/r.2021.05.065 |
[28] | 王振宇, 彭红军, 陈思, 等. 依托咪酯对老年冠心病患者非心脏手术中血流动力学及肌钙蛋白I和超敏C反应蛋白的影响[J]. 广东医学, 2016, 37(1): 216-218. |
[29] | 杨淑娟, 梁锦荣, 李盘石, 覃炳军. 血清cTnI、hs-CRP、NT-pro BNP联合检测对急性心肌梗死的诊断价值[J]. 山东医药, 2020, 60(2): 75-77. |
[30] | 王鑫鑫, 杜伟鹏, 杨柳. 血清CRP联合cTnI检验在急性心肌梗死患者诊断中的应用[J]. 临床研究, 2022, 30(11): 137-140. |
[31] | 罗友军, 谭转欢, 石小燕等. 血清CRP联合cTnI检验在急性心肌梗死诊断中应用探讨[J]. 中外医疗, 2014, 33(36): 11-12. https://doi.org/10.16662/j.cnki.1674-0742.2014.36.028 |