【摘要】目的 探讨急性冠状动脉综合征与肺栓塞的诊断与鉴别，为降低误诊率提供依据。方法 对18例被误诊为急性冠脉综合征的急性肺栓塞患者误诊情况与临床特点进行回顾分析。结果 18例中胸痛10例，呼吸困难14例，D-diner(D-二聚体)>520 μg/L；患者血气分析均为低氧血症；11例患者心电图ST-T改变。考虑诊断为急性肺栓塞原因：8例胸痛伴有严重低氧血症，6例冠状动脉造影结果正常，4例给予冠心病常规治疗无效。结论 因呼吸困难、胸痛被初诊为急性冠脉综合征的患者，如果临床资料不足以确诊时，特别对于冠心病常规治疗无效或低氧血症严重时，应考虑诊断为急性肺栓塞并行早日检查确诊。

    【关键词】急性冠脉综合征；肺栓塞；临床诊断；鉴别

    【中图分类号】R541.4 【文献标识码】B

    【Abstract】Objective To explore the acute coronary syndrome and the diagnosis of pulmonary embolism and to identify and provide the basis for reduce the misdiagnosis rate. Methods 18 cases misdiagnosed as acute coronary syndrome in patients with acute pulmonary embolism of misdiagnosis and clinical features were analyzed retrospectively. Results 18 cases ......