RESUMO
Objective: To explore the diagnostic value of 12 leads electrocardiogram (ECG) combined with detection of myocardial enzyme spectrum for atypical myocardial infarction. Methods: 80 patients with atypical myocardial infarction were enrolled in the observation group, and 80 patients with typical myocardial infarction in the same period were enrolled in the control group. Both of two groups were implemented the routine 12 leads ECG examination using FX-8322 ECG instrument, and the changes of Q wave and ST segment were recorded. And the series of indicators of serum myocardial enzymes (CK, CK-MB and cTnI) were detected by using AU2700 automatic biochemical analyzer. The test results of the first symptoms, ECG characteristics, myocardial enzyme spectrum and diagnostic accuracy of the two groups were compared. Results: In 80 patients of observation group, the painless first symptom was 20%, and the atypical pain was 75%, the typical upper abdominal and back pain accounted for 5%. In 80 patients of control group, all of them were typical upper abdominal and back pain, and the differences of these indicators between the two groups were significant (x2=8.889, x2=48.000, x2=72.381, P<0.05). For characteristics of ECG, the 22.5% of 80 patients of observation group hasn't been changed at ST-T segment, and the 17.5% of them was no pathological Q wave +T wave erect +ST segment elevation, and the percentage of pathological Q wave +T wave erect +ST segment elevation in observation group was 60.0%. On the other hand, the 100.0% of 80 patients of control group was pathological Q wave+T wave inverted +ST segment elevation, the differences of these indicators between the two groups were significant (x2=10.141, x2=7.671, x2=20.000, P<0.05). The results of myocardial enzyme spectrum detection indicated that the levels of serum CK, CK-MB and cTnI in the observation group were significantly lower than those in the control group (t=59.766, t=20.735, t=13.352, P<0.05), respectively. The diagnostic accuracy rate of ECG in observation group was 87.5%, which was significantly lower than 100% in control group (x2=5.333, P<0.05). The accuracy rate of ECG combined with myocardial enzyme spectrum in the observation group was 100%, which was not statistically significant compared with that in control group. Conclusion: 12 leads ECG is effective in diagnosing typical myocardial infarction, but it is necessary to combine myocardial enzyme spectrum detection for atypical myocardial infarction so as to increase the diagnostic accuracy rate.