12导动态心电图在评价心肌桥引起心肌缺血患者中的临床价值  

The clinical values of 12 lead dynamic electrocardiogram on evaluating myocardial bridge in patients with myocardial ischemia

作　　者：马跃新 张广宏 仇军 郭宏杰 党楠楠 

机构地区：[1]北京中医医院顺义医院,北京101300

出　　处：《西部医学》2017年第3期359-362,共4页Medical Journal of West China

基　　金：北京市科技计划课题(z151100003919187);顺义区科技计划项目(201501)

摘　　要：目的探讨12导动态心电图在评价心肌桥引起心肌缺血患者中的临床价值。方法选择2013年2月~2016年1月在北京中医医院顺义医院住院经冠状动脉造影确诊为冠心病心肌桥患者98例进行12导动态心电图检查,记录与观察心肌缺血情况、心肌桥情况与预后情况,同时进行相关性对比分析。结果在98例患者中,冠状动脉造影诊断为单支病变(单支病变组)40例,多支病变(多支病变组)58例。12导动态心电图判断为心肌缺血者87例,心肌缺血检出率为88.8%,其中多支病变组的检出率、发作次数、总持续时间与ST段压低幅度都明显多于单支病变组(P<0.05)。12导动态心电图判断为浅表型70例,深在型28例;心肌桥长度为(18.34±4.19)mm,心肌桥狭窄程度为(58.13±11.74)%,同时多支病变组的心肌桥情况与单支病变组对比,差异都有统计学意义(P<0.05)。所有患者出院后随访至今,发生主要不良心脏事件8例,发生率为8.2%,同时多支病变组的不良心脏事件发生率明显高于单支病变组(P<0.05)。结论 12导动态心电图可以较直观准确地评价冠心病心肌桥患者的心肌缺血状况,能指导预测预后不良心脏事件,且多支病变患者动态心电图ST段变化更明显,并且12导动态心电图也具有无创、安全性高等优点,值得临床推广应用。Objective To investigate the clinical values of 12 lead dynamic electrocardiogram in evaluating myocardial bridge in patients with myocardial isehemia. Methods From February 2013 to January 2016, 98 patients with coronary myocardial bridge confirmed by coronary arteriography were selected in Shunyi hospital of Beijing Chinese medicine hospital. All patients were given the 12 lead dynamic electrocardiogram detecting, recorded and observed the myocardial ischemia, myocardial bridge and prognosis. Results In the 98 cases, the diagnosis of coronary angiography were 40 cases of single vessel disease （single branch group） and 58 cases with multiple lesions （multi branch group）. There were 87 patients with myocardial ischemia for predicting by the 12 lead dynamic electrocardiogram. The myocardial isehemia detection rate was 88.8%. The detection rate, total duration and ST segment depression range of the multi branch group were significantly higher than the single branch group （P〈0.05）. 12 lead dynamic electrocardiogram judgment for 70 cases were superficial type. The deep type were 28 cases. The length of myocardial bridge were （18.34±4.19）mm, and the stenosis degree of myocardial bridge were （58.13±11.74） %. The length of myocardial bridge and stenosis degree of myocardial bridge in the multi branch group compared to the single branch lesion group had statistical differences significance （P〈0. 05）. All patients were followed up after discharge, and there were 8 cases of major adverse cardiac events. The incidence rate was 8.2V0, while the branch group of adverse cardiac events was significantly higher than that of single vessel disease group （P〈0. 05）. Conclusion 12 lead dynamic electrocardiogram can be more intuitive accurate evaluation of myocardial ischemia in patients. The changes of ST segment of dynamic electrocardiogram is more significant in patients with multiple lesions, so as to guide the prediction prognosis of adverse cardiac events and also with noninvasive,high safety

关 键 词：12导动态心电图 心肌桥 心肌缺血 冠心病 冠状动脉造影 

分 类 号：R540.4[医药卫生—心血管疾病]