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在动态心电图上,发现一过性心肌缺血的稳定型和不稳定型心绞痛患者的预后不良。在急性心(肌)梗(死)患者,不论是否伴有严重左室功能受损或严重窦性心律失常,动态心电图上 ST 段压低(STD)者一年死亡率都成倍上升。但其与临床指标相比的独立预测价值,以及 STD 的频度、持续时间和幅度的预后意义尚不清楚。本文旨在对此作进一步探讨。方法:以203例急性心梗患者为对象。201例在早期(3～15天,平均6天),177例在晚期(22～93天,平均38天),用 Oxford Medilog 400-Ⅱ型机,主要取CM_s,导联查24小时动态心电图。阳性标准:≥30秒的ST 段水平型或下斜型压低≥1.0mm;若本来卧位 STD≥0.5mm,则须另外压低1.0mm以上。随后至少一年。结果:STD 在早期检查阳性率为14%、晚期为32%,且极大多数(早期85%,晚期94%)无症状。住院
On the ambulatory ECG, patients with stable and unstable angina who have been found to have transient myocardial ischemia have a poor prognosis. In acute myocardial infarction (AMI) patients, the one-year mortality rate of ST segment depression (STD) on the ambulatory ECG doubled with or without severe left ventricular dysfunction or severe sinus arrhythmia. However, its independent predictive value compared with clinical indicators and the prognostic significance of the frequency, duration and magnitude of STD are not clear. This article aims to further explore this. Methods: 203 patients with acute myocardial infarction as the object. 201 cases in the early (3 to 15 days, an average of 6 days), 177 cases in the late (22 to 93 days, an average of 38 days) with the Oxford Medilog 400-Ⅱ-type machine, the main take CM_s, leads check 24-hour Holter . Positive criteria: ≥ 30 seconds of ST-level horizontal or down oblique pressure ≥ 1.0mm; if the original lying STD ≥ 0.5mm, then the other to be down more than 1.0mm. Then at least a year. Results: The positive rate of STD was 14% in the early stage and 32% in the late stage, and the vast majority (85% in early stage and 94% in late stage) were asymptomatic. Hospitalized