应用动态心电图心肌缺血总负荷对经皮腔内冠状动脉成形术的疗效观察

Holter monitoring follow-up in patients after percutaneous transluminal coronary angioplasty

对５２例冠状动脉造影显示管径狭窄≥７０％而成功进行经皮腔内冠脉成形术（ＰＴＣＡ）治疗的患者进行动态心电图追踪。结果提示：（１）ＰＴＣＡ术后１周动态心电图心肌缺血总负荷较术前明显降低（Ｐ＜０．０５），术后１个月、６个月及１年降低更为显著（Ｐ均＜０．０１）。（２）ＰＴＣＡ术主要改善劳力型心肌缺血，术后各阶段均较术前显著改善（Ｐ均＜０．０１）；自发型心肌缺血在术后１周改善不明显，远期有明显改善（Ｐ分别＜０．０５及０．０１）。（３）动态心电图观察术后冠心病患者的无症状心肌缺血有明显改善（Ｐ分别＜０．０５及０．０１）。

Abstract Fifty-two patients underwent successful percutaneous transluminal coronary angioplasty (PTCA) were studied with Holter monitoring, in the follow-up period. The results showed that (1), The total ischemic burden in one week, at one month, at six months and at one year after PTCA were significantly decreased in comparing with that before PTCA (P<0.05 and 0.01 , respectively). (2) PTCA mainly improved ischemic burden during effort (P< 0.01). The rest ischemic burden did not improve in one week after PTCA(P>0.1), but improved later(p<0.05). (3)PTCA could improve silent myocardial ischemia significantly (P<0.05), especially at one month, six months and one year after PTCA (P<0.01). Thus,Holter monitoring after PTCA may be a valuable method in estimating the short-term and long-term effect of PTCA and also helpful in discovering restenosis.