冠心病心肌缺血发生规律的临床观察

ACLINICAL STUDY OF RHYTHMS OF MYOCARDIAL ISCHEMIA IN PATIENTS WITH CORONARY HEART DISEASES

对１０８例心绞痛患者经动态心电图监测６３６次缺血性ＳＴ段下移资料分析，结果表明：（１）在心绞痛患者缺血性ＳＴ段下移中，无症状性心肌缺血占７５％，发生次数是有症状性的３倍；（２）心肌缺血的发生７７．２％与活动有关；（３）心肌缺血有明显的昼夜分布规律，以上午６－１０时为发作高峰，占全天发作总次数的３２．２％。提示在冠心病的治疗中应重视包括无症状性心肌缺血在内的总缺血负荷，并应结合缺血发生的昼夜分布规律改进临床治疗。

The data of 636 episodes of ischemic ST segment depression in 108 patients with angina pestoris were studied by 24 hour ambulatory electrocardiogram, The results are as follows first the patients with silent myocardial ischemia amount to 75% of all patients with ischemia,which is three times as many as symptomatic myocardial ischemia Second 77.2% patients with ischemic ST segment depression relate to labour.Myocardial ischemia has a clear circadian variation.The frequency of change peaks at 6-10 am,which amounts to 32.2% of the whole day. It suggests that the total ischemic burden,including silent myocardial ischemia, should be paid much atlention in the treatment of coronary artery disease.Meanwhile,we should adjust treatment according to day and night regularity of ischemic attack.