动态心电图对冠心病无症状心肌缺血的诊断价值 熊琳.docVIP

精品论文 参考文献 动态心电图对冠心病无症状心肌缺血的诊断价值 熊琳 熊琳 　　四川省司法警官总医院功能科心电图室 ，610000 　　【摘要】目的：探讨动态心电图对冠心病无症状心肌缺血(SMI)的诊断价值。方法：选择经冠脉造影确诊为冠心病的92例患者作为研究对象，所有患者造影前均已行动态心电图检查。采用动态心电图记录结合患者生活日志分析诊断及结果。结果：65例符合心肌缺血性ST段压低发作要求，占总例数的70.7%，其中共发生缺血性ST-T改变287阵次，其中SMI发生率(78.0%，224/287)明显高于症状性心肌缺血发生率(22.0%，63/287)(Plt;0.05)。06：00～12：00 SMI发生率(53.6%，120/224)最高，0：00～06：00SMI发生率(8.9%，20/224)最低，差异有统计学意义(Plt;0.05)。SMI发作时185阵次伴平均心率ge;85次/min(82.6%)明显高于39阵次伴平均心率lt;85次/min(17.4%)(Plt;0.05)。结论：动态心电图是检查冠心病无症状心肌缺血的有效方法。 　　【关键词】动态心电图；无症状心肌缺血；冠心病 　　The diagnostic value of dynamic electrocardiogram monitoring for silent myocardial ischemia 　　Xiong Lin 　　ECG room of functional department, the general hospital of judicial police officer of Sichuan 610000 　　[Abstract] Objective To investigate diagnostic value of DCG(Dynamic Electrocardiogram) monitoring for silent myocardial ischemia. Methods 92 patients who had been diagnosed by coronary angiography as coronary heart disease were selected as study object. All patients were detected with DCG monitoring before coronary angiography. The diagnostic and results were analysis on the records of 24-hour Holter combined with Life log. Results There were 65 cases(70.7%) who had ischemic ST-segment changes, and ischemic ST-segment changes were 287 episodes. In these cases, silent myocardial ischemia were higher than symptoms of myocardial ischemia(78.0% VS 22.0%, Plt;0.05). Most frequent time happened myocardial ischemic was 06:00 to 12:00, while least frequent time happened myocardial ischemic was 0:00 to 06:00. When SMI attacks, it had faster heart rate, 185 episodes correlate with the mean heart rate ge;85 bpm(82.6%), 39 episodes correlate with the mean heart ratelt;85bpm(17.4%)(Plt;0.05). Conclusion Dynamic Electrocardiogram(DCG) is the effective method for silent myocardial ischemia. 　　[Key words] Dynamic electrocardiogram; Silent myocardial ischemia; Coronary heart disease 　　心电图检查以快捷方便、无创及重复性好著称，是临床诊断及监测的重要方式。而动态心电图和常规心电图不同，动态心电图能够在24 h之内连续记录10 万次左右的心电信号。动态心电图是一种能够连续进行