24h动态心电图检测冠心病无症状心肌缺血阈的临床分析

Threshold of Myocardial Ischemia by Ambulatory Electrocardiogram

目的探讨动态心电图对冠状动脉粥样硬化性心脏病(冠心病)病人无症状心肌缺血阈值的临床意义。方法53例冠心病病人24h心电图检测其心肌缺血阈值、心肌缺血阈值的变异度、每阵缺血发作持续时间和ST段最大位移,以及昼夜缺血次数。结果共检出468例缺血发作,以心率加快时心肌缺血居多,达91.2%,夜间心肌缺血阈值较低,且缺血持续时间及ST段压低程度明显长于及重于白昼。心肌缺血阈的变异度为22.3%,与缺血总阵数呈正相关。结论高心肌缺血阈与心肌耗氧量有关,低心肌缺血阈与冠状动脉张力有关。

Objective To evaluate clinical significance of silence myocardial ischemic threshold by ambulatory electrocardiogram. Methods Fifty - three cases with coronary disease were investigated by 24 hour ambulatory electrocardiogram. The myocardial ischemic threshold, variability of myocardial ischemic threshold, and duration of ischemic episodes were observed. Results There were 91.2% fast heart rate and ST depression among 468 ischemic episodes and noctural ischemias had lower threshold longer mean ischemic time as well as deeper ST depression. It is 22.3 % that the variability of the myocardial ischemia was 22.5 %. Conclusion The results suggested the nigher the myocavdial isehemic threshold, the more myocardial oxyen consumption.