摘要
Abstract
Objective To explore the clinical features and related mechanisms of community acquired pneumonia ( CAP) complicated with acute myocardial infarction ( AMI ) in order to reduce missed diagnosis and misdiagnosis rates . Methods According to complication conditions , 593 patients with AMI admitted to Sichuan Provincial Armed Police Force Hospital during July 2008 and March 2015 were divided into CAP group ( n=47 ) and non-CAP group ( n=546 ) .General conditions, comorbidities, clinical symptoms, and treatment outcomes in the two groups were compared .Missed diagnosis and misdiagnosis were analyzed in CAP group .Results Compared with non-CAP group, CAP group had older age , higher inci-dence rate of comorbidities ( including diabetes , old myocardial infarction , chronic obstructive pulmonary disease ) , lower in-cidence rate of chest pain, and higher incidence rate of arrhythmia , acute left ventricular failure, dyspnea, cardiogenic shock, and gastrointestinal bleeding .The difference was statistically significant (P<0.05).19 patients of CAP group were not diag-nosed within 24 hours after AMI occurred , and 15 patients were diagnosed within 24-48 hours, 4 patients were diagnosed with-in 48-72 hours.Among them, 14 patients were miss diagnosed , 3 patients were misdiagnosed with acute exacerbation of chro-nic obstructive pulmonary disease , and 2 patients were misdiagnosed with chronic gastritis .The 19 patients were finally diag-nosed with CAP complicated with AMI according to relative diagnostic criteria after related examinations .After corresponding relative treatment, improvement rate in CAP group was lower , and fatality rate was higher than that in non-CAP group.Differ-ences were statistically significant (P<0.05).Conclusion Clinical syndromes of AMI complicated with CAP is usually atyp-ical, with high rates of missed diagnosis , misdiagnosis, and fatality.关键词
肺炎/心肌梗死/漏诊/误诊/肺疾病,慢性阻塞性Key words
Pneumonia/Myocardial infarction/Missed diagnosis/Misdiagnosis/Pulmonary disease , chronic obstruc-tive分类
医药卫生
