动态心电图对无症状性心肌缺血的诊断价值

Clinical diagnosis of asymptomatic myocardial ischemia in coronary heart disease patients by 24h Holter monitoring

目的 探讨24 h动态心电图检查对无症状性心肌缺血的诊断价值. 方法 应用24 h动态心电图对80例无症状心肌缺血冠心病（CHD）患者进行检测,并记录结果. 结果 在80例CHD患者中发生心肌缺血者75例,占93.75%,共发生缺血性ST段下移824阵次,每例发作1～23阵次,平均8.3阵次,平均ST段下移（0.15±0.06）mV;无症状心肌缺血大多发生在白天,发作高峰位于6～12 h出现最少;心率增快的高低与缺血的程度呈正相关,心率越快,ST段下移越明显,诱发的心肌缺血越严重. 结论 24 h动态心电图检查对元症状性心肌缺血病情评估和早期防治有重要意义.

Objective To investigate the effect of 24h Holter monitoring in patients with asymptomatic myocardial ischemia diagnosis. Methods 80 patients with asymptomatic myocardial ischemia in coronary heart disease（CHD）were detected by 24h Holter monitoring,and the results were recorded. Results In 80 patients of CHD myocardial ischemia occurred in 75 cases,accounting for 93.75%,and ischemic ST segment depression appeared total of 824 matrix times,and in each case there were 1 to 23 matrix times,an average of 8.3,and the average ST segment depression was（0.15±0.06）mV; Most of asymptomatic myocardial ischemia occurred in the daytime,and the peak onset occured in 6 to 12 hours; High and low heart rate was positively correlated with the degree of ischemia,and faster heart rate was,more obvious ST segment depression was down,more serious myocardial ischemia was induced. Conclusion 24h Holter monitoring of asymptomatic myocardial ischemia condition assessment and early prevention is important.