老年冠心病无症状心肌缺血的动态心电图分析

Analysis on Holter of Subclinical Myocardial Ischemia in Elderly Patients with Coronary Heart Disease

目的：探讨24h动态心电图（Hoher）对老年冠心病患者无症状心肌缺血（SMI）的检出情况和发生规律。方法：回顾分析我院门诊及住院328例老年冠心病患者的Holter和临床资料。结果：常规心电图检出心肌缺血101例（30．79％），Holter检出心肌缺血211例（64．33％）；SMI发生率为67．77％，有症状心肌缺血发生率为29．6％；SMI发作有明显的生物节律，多以清晨5～12时发作频率最高，且发作时心率减慢的比例明显低于有症状心肌缺血（P〈0．005）；SMI的心律失常检出率为87．84％。结论：Hoher可早期发现老年人的无症状心肌缺血，这有助于对老年冠心病的病情评估和早期防治。

Objective： To study the Hoher＇s function to eldely coronary heart disease SMI＇s detection condition and occurrence rule. Method： Three hundred and twenty-eight inpatient and outpatient with coronary heart diseaseb holter and clinical data were reviewed and analyzed. Results： Myocardial isehemia 101 eases（30.79% ） are checked out by general ECG ,211 eases（64.33% ） by Holter; SMI incidence rate is 67.77%, myocardial ischemia incidence rate is 29.6%. SMI＇ s occurrence has obvious biological rhythm and of. len happens at 5：00 ～12：00 am, the percent of SMI＇ s cardiac rate decreasing are less than myocardial isehemia （P 〈 0. 005 ）. SMI＇ s arrhythmia detection rate is 87.84%. Conclusion： Elderly SMI can be checked out earlier by Holter. It helps a lot to elder coronary heart disease evaluation and earlier prevention and cure.