冠心病无症状性心肌缺血诊断中应用动态心电图的临床效果分析  

Analysis of clinical effect of Holter electrocardiogram in diagnosis of asymptomatic myocardial ischemia in coronary heart disease

作　　者：曹秋叶 CAO Qiu-ye(Fujian Medical University Affiliated Nanping First Hospital,Nanping 353600,China)

机构地区：[1]福建医科大学附属南平第一医院,353600

出　　处：《中国现代药物应用》2024年第17期72-75,共4页Chinese Journal of Modern Drug Application

摘　　要：目的 分析冠心病无症状性心肌缺血采取动态心电图进行诊断的效果。方法 选取200例冠心病心肌缺血患者为研究对象,均进行动态心电图连续检查。将冠状动脉造影检查作为诊断的金标准,分析动态心电图对冠心病无症状性心肌缺血的诊断效能;分析动态心电图的诊断结果。结果 200例冠心病心肌缺血患者,经冠状动脉造影诊断显示无症状性心肌缺血患者113例,有症状性心肌缺血患者87例。动态心电图诊断显示无症状性心肌缺血患者105例,有症状性心肌缺血患者95例。动态心电图诊断冠心病无症状性心肌缺血的漏诊率为14.2%(16/113),误诊率为9.2%(8/87),灵敏度为85.8%(97/113),特异度为90.8%(79/87)。200例冠心病心肌缺血患者通过动态心电图诊断,有症状性心肌缺血患者95例、占比47.5%(95/200),24 h内共发作182次心肌缺血,其中0:00~5:00发作67次、占比36.8%,6:00~24:00发作115次、占比63.2%。无症状性心肌缺血患者105例、占比52.5%(105/200),24 h内共发作278次心肌缺血,其中0:00~5:00发作63次、占比22.7%,6:00~24:00发作215次、占比77.3%。无症状性心肌缺血患者ST段下移持续时间为(13.5±4.6)min/次,有症状性心肌缺血患者ST段下移持续时间为(30.1±10.9)min/次,无症状性心肌缺血患者ST段下移持续时间短于有症状性心肌缺血患者,差异具有统计学意义(P<0.05)。结论 对于冠心病无症状性心肌缺血采取动态心电图进行诊断的临床价值高,可以显著提升检出率,对于评估冠心病无症状性心肌缺血存在非常重要的意义。Objective To analyze the effect of Holter electrocardiogram in the diagnosis of asymptomatic myocardial ischemia in coronary heart disease.Methods 200 coronary heart disease patients with asymptomatic myocardial ischemia were selected as the study subjects.Using coronary angiography as the gold standard,the diagnostic efficiency of Holter electrocardiogram for asymptomatic myocardial ischemia in coronary heart disease was analyzed.The diagnostic results of Holter electrocardiogram were analyzed.Results Among 200 patients with coronary heart disease,113 patients had asymptomatic myocardial ischemia by coronary angiography and 87 patients had symptomatic myocardial ischemia.Among 200 patients with coronary heart disease,95 patients with symptomatic myocardial ischemia,accounting for 47.5%(95/200),with 82 episodes of myocardial ischemia within 24 h,of which 67 episodes occurred between 0:00 and 5:00 in the morning,accounting for 36.8%,and 115 episodes occurred between 6:00 and 24:00,accounting for 63.2%.105 patients with asymptomatic myocardial ischemia,accounting for 52.5%(105/200),with 278 episodes of myocardial ischemia within 24 h,of which 63 episodes occurred between 0:00 and 5:00 in the morning,accounting for 22.7%,and 215 episodes occurred between 6:00 and 24:00,accounting for 77.3%.The duration of ST segment depression was(13.5±4.6) min/time in asymptomatic myocardial ischemia patients,and(30.1±10.9) min/time in symptomatic myocardial ischemia patients;the duration of ST segment depression in asymptomatic myocardial ischemia patients was shorter than that in symptomatic myocardial ischemia patients,and the difference was statistically significant(P<0.05).Conclusion The application of Holter electrocardiogram in the diagnosis of asymptomatic myocardial ischemia in coronary heart disease has high clinical value,which can significantly improve the detection rate,and is of great significance for the evaluation of asymptomatic myocardial ischemia in coronary heart disease.

关 键 词：冠心病 无症状性心肌缺血 动态心电图 诊断价值 

分 类 号：R541.4[医药卫生—心血管疾病] R540.41[医药卫生—内科学]