165例无症状性心肌缺血的动态心电图分析

Analysis of Dynamic Electrocardiograms for 165 Cases of Silent Myocardial Ischemia

目的探讨动态心电图对无症状性心肌缺血的诊断价值。方法应用Holter对165例无症状性心肌缺血患者记录日常生活活动并进行分析。结果 165例冠心病患者中共检出缺血性sT段改变589阵次,其中471阵次(80%)属无症状性心肌缺血,而有症状发作118阵次(20%)。SMI发作时间大多集中在06:00-10:00,占60%;16:00-17:00,占30%;其他时间占10%。结论 Holter是评价SMI的重要工具,能明确心律失常的种类、心肌缺血发作次数、持续时间和演变规律,可为临床早期诊断提供重要依据。

Objective To explore the diagnostic value of dynamic electrocardiogram in silent myocardial ischemia（SMI）. Methods A total of 165 patients with SMI were examined with 24h dynamic electrocardiogram and the results were analyzed. Results The episodes of sT segment depression were 589 among the 165 patients with coronary artery disease,in which 471 were SMI（80%） and 118 were ischemia with symptoms（20%）.The peak emergence time of SMI was between 6 am to 10 am,accounting for 60%.The SMI occurred between 16 pm to 17 pm accounted for 30%,and 10% occurred in the other time. Conclusions Dynamic electrocardiogram obviously improves the detection rate of coronary heart disease.It is an important clinical detection means of SMI,and it has an important clinical significance in clinical assessment and prognostic evaluation of silent myocardical ischemia.Dynamic electrocardiogram is an important clinical detection means of SMI,which can confirm the types of arrhythmia,the frequency of myocardial ischemia,endurance time of myocardial ischemia,and development regularity.It provides an important proof for early clinical diagnosis.