动态心电图在评价无痛性心肌缺血中的应用  

Research on the value of holter monitoring in the evaluation of silent myocardial ischemia

作　　者：马晓华[1] 闵煜榕[1] 张启高[1] 

机构地区：[1]南京大学临床医学院附属金陵医院心血管内科,江苏南京210002

出　　处：《中国医学装备》2015年第3期40-42,共3页China Medical Equipment

摘　　要：目的：探讨动态心电图在评价无痛性心肌缺血（SMI）中的价值。方法：对68例临床已确诊为心肌缺血的患者进行24 h动态心电图监测,并对结果进行分析。结果：68例患者中共检出295阵次SMI,其中05：00∽12：00时间段中发生率最高,共计发生156阵次,占总次数的52.88%;发生率次高的时间段为18：00∽22：00,共计发生97阵次,占总次数的32.88%;22：00至次日05：00时间段中发生率最低,共计发生46阵次,占总次数的15.59%。有诱发因素的SMI共计187阵次,占总次数的63.34%。心率≥100 bpm时,SMI共计发生175阵次,占总次数的59.32%;心率〉65 bpm〈100 bpm时,SMI共计发生78阵次,占总次数的26.44%;心率≤65 bpm时,SMI共计发生42阵次,占总次数的14.23%。其发作具有明显的节律性,多有明显的诱发因素,与心率的增加呈正相关。结论：动态心电图是临床监测SMI的重要手段,对无痛性心肌缺血的临床评估有重要的意义。Objective： To investigate the value of the Holter monitoring in silent myocardial ischemia（SMI）. Methods： Sixty-eight patients with silent myocardial ischemia had the Holter monitoring. Results： Sixty-eight cases were detected 263 times of the SMI, Among them 05：00-12：00 highest incidence occurs 156 times total, 52.88% of the total number; second highest incidence of the time period of 18：00-22：00, total occurred 97 times, the total number of of 32.88%; 22：00-05：00 totaling occurred 46 times, the total number of 15.59%. There are a total of 187 predisposing factors array times, 63.34% of the total number. Heart rate greater than 100 bpm, SMI total array occurred 175 times, 59.32% of the total number; heart rate65 bpm and when 100 bpm, SMI total array occurred 78 times, 26.44% of the total number; heart rate when 65 bpm, SMI total occurred 42 array times, 14.23% of the total number. It has obvious predisposing factors and is related to increasing heart rate. Conclusion： Holter is the main and important method to monitor and evaluate silent myocardial ischemia.

关 键 词：动态心电图 无痛性心肌缺血 心率 

分 类 号：R542.2[医药卫生—心血管疾病]