动态心电图对心肌缺血诊断价值的研究进展

Research progress on the value of dynamic electrocardiogram in the diagnosis of myocardial ischemia

心肌缺血主要是指患者的冠状动脉血流绝对或者相对减少,进而诱发机体出现心肌缺氧、缺血等情况,且需要根据患者是否存在胸口疼痛等症状,将其分为有症状型心肌缺血或者无症状型心肌缺血两种不同类型。相关研究结果显示,冠心病心肌缺血患者存在胸疼症状的比例大约为25%,而无症状的患者则大约占75%。大约20%~60%的稳定性心绞痛患者缺少典型的心肌缺血症状,因此容易出现误诊以及漏诊的情况。现阶段,临床诊断心肌缺血患者的主要方法包括冠状动脉造影检查、动态心电图、心脏超声、CT检查等。动态心电图具有方便、无创、不影响生活质量等检查优势,且动态心电图的检查费用比较便宜,医生能够通过患者检查结果,对患者进行初步的临床判断。本文针对动态心电图对心肌缺血患者的疾病诊断指标、方法及临床价值进行综述,为心肌缺血临床诊断提供借鉴方案。

Myocardial ischemia mainly refers to the absolute or relative reduction of coronary blood flow in patients,which leads to myocardial hypoxia and ischemia. According to whether patients have chest pain and other symptoms,they are divided into two different types:symptomatic myocardial ischemia or asymptomatic myocardial ischemia. Relevant research results show that the proportion of chest pain symptoms in patients with coronary heart disease and myocardial ischemia is about 25%,while the proportion of asymptomatic patients is about 75%. About 20%-60% of patients with stable angina pectoris lack typical symptoms of myocardial ischemia,so they are prone to misdiagnosis and missed diagnosis. At present,the main methods of clinical diagnosis of patients with myocardial ischemia include coronary angiography examination,dynamic electrocardiogram,cardiac ultrasound,CT examination and so on.Dynamic electrocardiogram has the advantages of convenience,noninvasive and no impact on the quality of life. The cost of dynamic electrocardiogram is relatively cheap. Doctors can make a preliminary clinical judgment on patients through the patient’s examination results. This paper reviews the disease diagnostic indexes,methods and clinical value of dynamic electrocardiogram in patients with myocardial ischemia,so as to provide a reference scheme for the clinical diagnosis of myocardial ischemia.