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目的:探讨老年男性冠心病患者无症状心肌缺血的发作特点及动态心电图诊断的价值。方法:行动态心电图检查老年男性冠心病患者350例,按年龄分为Ⅰ组(220例)和Ⅱ组(130例),对2组患者动态心电图结果进行对比分析,并与常规心电图结果进行比较。结果:Ⅱ组常规心电图、动态心电图心肌缺血检出率及无症状心肌缺血平均持续时间均高于Ⅰ组,但差异无统计学意义(P>0.05);Ⅰ组无症状心肌缺血发作有明显昼夜节律,Ⅱ组无明显昼夜节律;2组慢频率依赖型无症状心肌缺血持续时间均较快频率依赖型无症状心肌缺血延长(P<0.05),且Ⅱ组较Ⅰ组明显;快频率依赖型无症状心肌缺血平均ST段压低幅度与慢频率依赖型无症状心肌缺血平均ST段压低幅度比较,以及Ⅰ,Ⅱ组无症状心肌缺血平均ST段压低幅度比较差异均无统计学意义(P>0.05)。结论:随着年龄增加,老年男性冠心病患者无症状心肌缺血发生率增高,且无症状心肌缺血持续时间延长;>80岁男性冠心病患者无症状心肌缺血发作无明显昼夜节律,慢频率依赖型无症状心肌缺血持续时间较快频率依赖型无症状心肌缺血显著延长。动态心电图是老年冠心病患者发生无症状心肌缺血的重要的检测和评估手段。
Objective: To investigate the characteristics of asymptomatic myocardial ischemia in elderly men with coronary heart disease and the value of dynamic electrocardiogram. Methods: 350 patients with coronary heart disease were examined by ambulatory electrocardiogram in our hospital. The patients were divided into two groups according to their age: group Ⅰ (220 cases) and group Ⅱ (130 cases). The results of electrocardiogram were compared with those of conventional electrocardiogram . Results: The detection rate of myocardial ischemia and the duration of asymptomatic myocardial ischemia in group Ⅱ were higher than those in group Ⅰ, but the difference was not statistically significant (P> 0.05). The incidence of asymptomatic myocardial ischemia in group Ⅰ There was a significant circadian rhythm, and there was no obvious circadian rhythm in group Ⅱ. The duration of slow-onset frequency-dependent asymptomatic myocardial ischemia was prolonged in both groups (P <0.05) ; The frequency of ST-segment depression in fast-frequency-dependent asymptomatic myocardial ischemia compared with the mean frequency of ST-segment depression in asymptomatic myocardial ischemia in type Ⅰ and group Ⅱ, and the mean ST segment depression in group Ⅰ and group Ⅱ No statistical significance (P> 0.05). CONCLUSIONS: As the age increases, the incidence of asymptomatic myocardial ischemia in elderly men with coronary heart disease increases and the duration of asymptomatic myocardial ischemia prolongs. There is no significant circadian rhythm in asymptomatic myocardial ischemia in men> 80 years of age Frequency-dependent asymptomatic myocardial ischemia lasting faster frequency-dependent asymptomatic myocardial ischemia was significantly prolonged. Holter monitoring in elderly patients with coronary heart disease is an important means of detection and evaluation of myocardial ischemia.