动态心电图对无症状性心肌缺血的诊断价值

目的:研究动态心电图对无症状性心肌缺血的临床诊断价值。方法:收集我院2014年6月-2015年6月我院接受诊治的冠心病(CAD)患者120例作为研究对象,采用动态心电图仪检测记录24h心电图信息,将动态心电图检测为心肌缺血的患者分为A组(无症状心肌缺血)、B组(有症状心肌缺血),比较两组患者基本信息、心肌缺血发作阵次、ST段下降幅度、ST段下降持续时间、心肌缺血阈变异性、心率及心率失常发生率。结果:120例CAD患者中有95例患者出现心肌缺血,其中A组66例(占69.47%),B组29例(占30.53%),差异显著(P0.05)。A组ST段阵次改变明显高于B组,A组ST段下降幅度、ST段下降持续时间、心肌缺血阈变异性明显低于B组(P0.05)。A、B两组患者心肌缺血发作表现出昼夜节律,在时间段6:00-12:00最高,在时间段0:00-6:00最低(P0.05)。A组患者平均心率显著低于B组患者,心律失常发生率显著高于B组(P0.05)。结论:动态心电图能够准确的诊断出无临床症状心肌缺血,使患者得到及时的治疗,值得临床推广应用。

Clinical Value of Dynamic Electrocardiogram in Detecting Asymptomatic Myocardial Ischemia

ABSTRACT Objective: To study the clinical value of dynamic electrocardiogram in detecting asymptomatic myocardial ischemia. Methods: 120 cases of coronary heart disease (CAD) in our hospital from June 2014 to June 2015 were selected. Patients with myocardial ischemia were detected by dynamic electrocardiogram for 24 hours and divided into group A(Symptomless myocardial ischemia)and group B (Symptomatic myocardial ischemia) according to the test results. The basic information, ST segment array time, ST segment depression in amplitude and duration, myocardial ischemia threshold variability, heart rate and incidence of arrhythmia were compared respectively. Results: Total of 95 patients of myocardial ischemia were detected in 120 CAD patients, there were 66 patients (69.47%) in group A and 29 patients (30.53%) in group B(P<0.05). The ST segment array time of group A was obviously higher than that of group B,ST segment depression in amplitude and duration, myocardial ischemia threshold variability of group A was obviously lower than those of group B(P<0.05). The attack was day and night circadian regularity in group A and group B,the highest frequency was in the morning 6:00-12:00, while minimum frequency at 0:00-6:00(P<0.05). The heart rate in group A was lower than that of group B. The incidence of arrhythmia in group A was higher than that group B. Conclusion: Dynamic electrocardiogram can accurately diagnose asymptomatic myocardial ischemia,which make patients receive treatment timely, and can be widely applied clinically.