冠状动脉腔内成形术后心肌再灌注的高频心电图观察

CLINICAL STUDY OF HIGH FREQUENCY ECG AND AFTER PTCA IN MYOCARDIAL REPERFUSION OF CORONARY ARTERY DISEASE

６０例冠心病人经皮冠状动脉腔内成形术（ＰＴＣＡ）治疗前后，进行系统高频心电图（ＨＦＥＣＧ）和心电图（ＥＣＧ）检测观察与对比分析。结果：治疗成功者５３例，ＰＴＣＡ前平均血管狭窄７８．７％，±１．６％，ＨＦＥＣＧ高频切迹总数为７９４个（Ｎ＝１４．２８±３．３２）。ＰＴＣＡ后平均血管残余狭窄为１８．２±８．５％，高频切迹总数减少为４２７个（Ｎ＝９．２８±２．０８），治疗前后相比，高频切迹总数有显著差异（Ｐ＜０．０１）。ＰＴＣＡ治疗失败者７例，治疗前后高频心电图上分别为９５个和８９个高频切迹，（Ｎ＝１３．２９±２．０８和Ｎ＝１３．４８±３．１５），两者比较无统计学上差异。ＰＴＣＡ后ＨＦＥＣＧ的好转率为６０．４％；ＥＣＧ的好转率２４．５％，两者比较有显著差异（Ｐ＜０．０１）。ＨＦＥＣＧ频谱分析，ＰＴＣＡ前为０．１５１３±０．１０４７，ＰＴＣＡ后为０．０８３３±０．０３７８，两者相比有显著统计学差异（Ｐ＜０．０１）。结果表明ＨＦＥＣＧ可做为评估ＰＴＣＡ后心肌再灌注疗效的一项较ＥＣＧ敏感性高的新的客观指标。

The procedures of percutaneans transluminal coronary angioplasty(PTCA)were performed in patients suffering coronary artery disease,53 cases treated with PTCA procedures were successful with a success rate of 88.32%.7 cases treated with PTCA procedures failed to respond to them which amount to 11. 66%.The main reason was that it was difficult to pass wire guider and ballon catheter. We observed the changes of high frequency ECG in 53 cases treated with PTCA,The result indicated that the number of high frequency notches grew along with the increase of obstruction degree of coronary arteries and ingury extent of myocardium and before therapy HFN 794,after therapy HFN 427(P<0.01).After PTCA HFECG effective rate is 24.5%(P<0.01).HFECG spectrogram analysis,the frequency range indicated before PTCA 0.1513±0.1047;after PTCA 0.833±0.0378(P<0.01).So,there should be more sensitivity in HFECG to the diagnosis of cardiac ischemia than ECG.