动态心电图诊断无症状性心肌缺血的价值  

The value of dynamic electrocardiography in the diagnosis of silent myocardial ischemia

作　　者：林永霞[1] 姚锦容[1] 黎文婷[1] 

机构地区：[1]中山市人民医院心电生理室,广东省中山市528403

出　　处：《中国心血管病研究》2015年第5期446-448,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨动态心电图诊断无症状性心肌缺血的临床价值.方法 选取2012年10月至2014年8月在本院确诊为冠心病的患者90例,进行24h动态心电图检测.结果 90例冠心病患者中检出心肌缺血75例（83.33％）,48 h内发生缺血性ST段下移1075阵次.其中有症状性心肌缺血27例（36.00％）,ST段下移155阵次（14.42％）,平均ST段下移（0.17±0.03）mV;无症状性心肌缺血48例（64.00％）,ST段下移920阵次（85.58％）,平均ST段下移（0.16±0.02）mV.无症状性心肌缺血发作主要在6：00-18：00,其中6：00-12：00最多,白天发作是夜间发作的2.48倍.48例无症状性心肌缺血患者的平均心率为65次/min,发作时心率＞65次/min者36例（75.00％）,≤65次/min者12例（25.00％）,伴有心律失常者41例（85.42％）.结论 动态心电图检测无症状性心肌缺血具有重要的临床诊断价值.Objective To investigate the clinical value of dynamic electrocardiography in the diagnosis of silent myocardial ischemla. Methods 90 cases of patients with coronary heart disease diagnosed in our hospital from October 2012 to August 2014, 24-hour dynamic electrocardiography testing was carried out. Results In 90 cases of patients with coronary heart disease, there were 75 cases （83.33%） of myocardial ischemia, ischemie ST segment depression occurred 1075 times array within 48 hours. There were 27 cases （36.00%） of symptomatic my- ocardial ischemia, ST segment depression occurred 155 times （14.42%）, the average ST segment depression was （0.17±0.03）mV. There were 48 cases （64.00%） of silent myocardial ischemia, ST segment depression occurred 920 times （85.58%）, the average ST segment depression was （0.16±0.02）mV. Silent myocardial ischemia attack was mainly in the 6：00-18：00, in which 6：00-12：00 was the most, the time during the day and nocturnal seizures 2.48 times. The average heart rate in 48 cases of patients with silent myocardial ischemia was 65 times/min, heart attack〉65 times/min were 36 cases （75.00%）, ≤ 65 times/min were 12 cases （25.00%）, accompanied by ar- rhythmia were 41 cases （85.42%）. Conclusion Dynamic electrocardiography in the diagnosis of silent myocardial ischemia has important clinical diagnostic value.

关 键 词：动态心电图 无症状性心肌缺血 冠状动脉疾病 

分 类 号：R540.41[医药卫生—心血管疾病]