论文部分内容阅读
目的探讨动态心电图在冠心病无症状性心肌缺血(SMI)诊断中的应用价值。方法对64例冠心病患者采用动态心电图连续监测24h,分析观察ST段下移次数,当时有无症状,以及ST段下移持续时间、发生的昼夜规律。结果经24h动态心电图检测,共发现心肌缺血性ST段下移464次,其中SMI发作385次(82.97%),有症状缺血发作79次(17.03%)。SMI持续时间(14.6±3.5)min/次,有症状性心肌缺血持续时间(31.2±9.8)min/次,两组比较,差异有统计学意义。72例心肌缺血持续时间平均(17.4±5.2)min,ST段压低值平均为(1.65±0.48)mm。385次SMI中,ST段下移发作高峰位于6～12时,196阵次(50.91%);12～18时共88阵次(22.86%);18～24时共55阵次(14.29%);夜间至凌晨6时出现最少46阵次(11.95%)。结论动态心电图对SMI诊断具有重要的临床价值,提高了检出率,对临床评估SMI具有重要意义。
Objective To investigate the value of Holter in the diagnosis of coronary heart disease (AMI) with silent myocardial infarction (SMI). Methods Sixty-four patients with coronary heart disease were monitored continuously for 24 hours by dynamic electrocardiogram. The number of downward movement of ST segment, the presence of asymptomatic symptoms, and the duration of ST segment depression were observed. Results After 24 h Holter monitoring, a total of 464 myocardial infarction (ST) segments were found, including 385 episodes of SMI (82.97%) and 79 episodes of symptomatic ischemic attack (17.03%). The duration of SMI was (14.6 ± 3.5) min / time and the duration of symptomatic myocardial ischemia was (31.2 ± 9.8) min / time. The difference between the two groups was statistically significant. The mean duration of myocardial ischemia was (17.4 ± 5.2) min in 72 patients, and (1.65 ± 0.48) mm in ST segment. In the 385 SMIs, the peak of the ST segment downward movement was located in the 196th (50.91%) at the time of 6-12, the 88th (22.86%) at 12-18, and the 55th (14.29%) at 18-24, ; At night to 6:00 appear at least 46 array (11.95%). Conclusion Holter monitoring has important clinical value for SMI diagnosis and improves the detection rate, which is of great significance for the clinical evaluation of SMI.