三导联动态心电图对无症状心肌缺血的诊断标准及价值初探

Preliminary study of the criteria and value of Dynamic Electrocardiograes to judge the silent myocardiol ischemia.

对700名就诊者分高血压、冠心病、其它疾病及青年体检组,以A和B两个标准分析三导动态心电图(DCG)对无症状心肌缺血(SMI)的诊断价值。(1)A标准:各组间ST下移或抬高次数无临床意义,其它疾病组的ST异常改变发生率达53.7％,假阳性率甚高;(2)B标准:心绞痛组缺血性ST改变的发生率为51.7％,而其它各组为9％～12.7％,前者ST缺血发作2.8h^(-1),而后者各组均≤1h^(-1)。B标准下DCG对SMI有一定价值但需结合临床。

For studing the criteria of dynamic electrocardiogram (DCG) to judge the silent myocardiol ischemia (SMI), we recommended A and B criteria to analyse 700 patients in four groups including patients with essential hypertension, coronary heart disease (CHD), non CHD patients and normal control. The results showed: (1)In criteria A, the frequency of ST segment elevation pression had no significant defference in four groups. The incidence of ST segment abnormal in non CHD groups reached 53. 7% which caused a high false positive rate; (2)In criteria B, the incidence of ischemia ST segment change in patients with angina pectoris was 51. 7% and only 9%-12. 7% in other groups. The frequency of ischemia ST segment change in angina pectoris patients were 2. 8 times an hour, but there were less than 1 time an hour in other groups. Thus we concluded that DCG is valuable to judge SMI in criteria B but need to combine with clinical analysis.