冠心病无症状性心肌缺血的动态心电图探讨

Exploration of DCG in Coronary Heart Disease with SMI

目的：为探讨冠心病无症状性心肌缺血的动态心电图（DCG）的临床特点。方法：对582例冠心病患者进行DCG监测。结果：402例有3884阵次缺血发作，其中307例2930阵次（75．44％）为无症状性心肌缺血（SMI），其中60岁以上者发作2135阵次，占SMI的72．87％，无症状与有症状组心肌缺血的ST段压低程度差异无显著性，但无症状较有症状组心肌缺血持续时间长（P〈0．05）。上午6：00～12：00SMI的发作频率最高（43．46％），明显多于夜间24：00～晨6：00的13．62％（P〈0．01）。栓出严重心律失常共327例，无症状与有症状组之间差异无显著性（P〉0．05）。结论：SMI栓出率远高于有症状心肌缺血，60岁以上者多见，容易引起患者忽视而得不到及时治疗，因此，更具有潜在危险，在诊治上应给予高度重视。

Objective To probe into the clinical features of theDCGin coronary heart disease with SMI. Methods 24h DCG detection for 582 patients with CHD. Results There are 3884 ischemic heart conditions attack in 402 patients ,in which 2930 in 307 patients are SMI （75.44%） ,and patient above 60 have SMI are 2135, that,s 72.87% in SMI . The low level ST in SMI and ischemia without symptoms has no apparent differences , but ischemic heart conditions last for longer time in SMI （ P 〈 0.05 ） . SMI attack frequency is higher in 6-12am （43.46%）, that, s obviously higher than in 0-6am 13.62% （ P 〈 0.01 ）. Serious arrhythmia in SMI and ischemia with symptoms have no obvious differences （ P 〉 0.05 ） , and is 327 cases in total . Conclusion The inspection of SMI is much more than ischemia with symptoms , and is frequently in people above 60. It, s easy to ignore by the patients so that they can, t treat it in time. Therefore, it has potential danger, so we should take great attention on it when we make a diagnosis and give treatment .