冠心病动态心电图检出的无症状心肌缺血分析

ANALYSIS OF SILENT MYOCARDIAL ISCHEMIA DETECTED WITH DYNAMIC ECG IN CORONARY HEART DISEASE

分析了８９例冠心病患者２４ｈ动态心电图的结果，７３例（８２％）检出缺血性ＳＴ段改变，共计２３２阵次，其中１７９阵（７７．２％）属无症状心肌缺血发作（ＳＭＩ），无症状组每阵缺血发作的平均持续时间明显长于有症状组（Ｐ＜０．００１）。１７９阵ＳＭＩ中１１８阵（６６％）发生于６～１８时，６１阵（３４％）发生于１８～６时；快频率缺血发作（ＦＲＩ）１３４阵（７４．９％），慢频率缺血发作（ＳＲＩ）４５阵（２５．１％）。ＳＭＩ在６～１８时的起始心率明显快于１８～６时者，ＦＲＩ与ＳＲＩ在ＳＴ段压低幅度与缺血时间上无显著差异。

in 89 cases of coronary heart disease monitored with dynamic electrocardiography (ECG) for 24 hours, ischemic ST segment changes were found in 73 cases ( 82%) with 232 paroxysms in which 179(77.2%) were of silent myocardial ischemia (SMI) . The paroxysm duration of SMI was significantly longer than that of symptomatic myocardial ischemia (P<0.001 ) . 118 of the 179 SMI paroxysms (66%)occured on the time from 6 to 18 o’clock, and 61 (34%) from 18 to 6o’clock; there were 134 (74.9%) frequent rate ischemia (FRI)paroxysms,and 4o (25. 1%) slow rate ischemia paroxysms (SRI) . The initial heart rate of SMI on the time from 6 to 18 o’clock was significantly higher than that on the time from 18 to 6 o’clock. There were no difference between FRI and SRI on the ST segment lowered and ischemiac duration.