动态心电图监测无症状心肌缺血的研究

Holter studies on the monitoring of the silent myocardial ischemia

用动态心电图监测７８例不同类型冠心病（ｃｏｒｏｎａｒｙｈｅａｒｔｄｉｓｅａｓｅ，ＣＨＤ）患者，结果：无症状心肌缺血（ｓｉｌｅｎｔｍｙｏｃａｒｄｉａｌｉｓｃｈｅｍｉａ，ＳＭＩ）检出率远高于有症状心肌缺血（二者之比９．２：１）；心肌梗塞后ＳＭＩ的ＳＴ压低持续时间较完全无症状性心肌缺血及心绞痛伴有的ＳＭＩ为长（Ｐ＜０．０１）；有症状的较无症状的为长（Ｐ＜０．０１）。提示缺血程度的不同，可能与冠脉病变程度及症状出现与否有关。同时根据ＳＭＩ发作规律及缺血时状态的不同以及与心率的关系，提出了心肌缺血发作的可能机制及相应的防治措施。

patients with coronary heart disease were monitored by Holter. The incidence of silent myocardial ischemia(SMI) was much higher than that of symptomatic myocardial ischemia(the ratio of the two 9.2:1). The duration of ST depression in SMI after myocardial infarction was longer than that in completely asymptomatic SMI and angina pectoris accompanied by SMI(P<0.01).The symptomatic one was longer than SMI(P<0.01). It was suggested that the ischemic degree may be related to the degree of the pathological changes of the coronary and the appearance of symptoms. According to the regularity of the SMI episode,the difference of ischemic conditions and the relation with the heart rate, the probable mechanism of the SMI episode and the measures for the prevention and treatment were discussed.