动态心电图对冠心病无症状性心肌缺血的诊断价值  

Diagnosis of holter monitoring for silent myocardial ischemia in coronary heart disease

作　　者：邓志妤[1] 陈敏[1] 黄明毅[1] 张平[1] 

机构地区：[1]深圳市龙岗中心医院心电图室,广东深圳518116

出　　处：《中国当代医药》2012年第3期40-42,共3页China Modern Medicine

摘　　要：目的探讨动态心电图对冠心病无症状性心肌缺血的临床诊断价值。方法随机抽取220例本院心内科收治的冠心病患者,采用动态心电图对其连续观测1d,然后回放分析ST段的位移值等指标。结果 220例患者中发生心肌缺血者201例(91.36%),共检测出心肌缺血671次,其中心肌缺血为568次(84.65%),显著高于有症状的心肌缺血(15.35%),P<0.05。心肌缺血阈变异性在早8点至晚6点之间和晚6点至早6点之间差异显著(P<0.05)。心肌缺血发作前后心率发生了显著差异变化。而ST下移也是在发作后显著大于发作前。结论动态心电图是诊断无痛心肌性缺血的较为理想的手段,是一种无创的辅助检查手段,对于冠心病患者的回访和疗效的评价有着重要的意义,值得推广。Objective To investigate the dynamic electrocardiogram of asymptomatic myocardial ischemia in coronary heart disease in clinical diagnosis.Methods Two hundred and twenty cases of patients with coronary heart disease were selected,continuous observe its dynamic ECG for 1 d,and then analyze ST segment displacement values and other indicators.Results Myocardial ischemia occurred in 201 cases（91.36%）,myocardial ischemia were detected for 671 times,including myocardial ischemia and 568 times（84.65%）,significantly higher than the symptoms of myocardial ischemia（15.35%）,P 0.05.Myocardial ischemic threshold variability in between 8：00 to 6：00 and 6：00 to 6：00 the difference between a relatively significant（P 0.05）.Before and after onset of myocardial ischemia occurred in significant differences in heart rate changes.The ST is also down significantly greater than after the onset of seizures before.Conclusion ECG diagnosis of painless myocardial ischemia is the ideal means,is a non-invasive means of the auxiliary examination for patients with coronary heart disease and efficacy evaluation of a return visit has important significance,worthy of promotion.

关 键 词：动态心电图 冠心病 无症状心肌缺血 诊断 

分 类 号：R540.4[医药卫生—心血管疾病]