动态心电图监测在变异性心绞痛中的应用

Application of dynamic electrocardiogram in variant angina pectoris

目的探讨动态心电图在变异性心绞痛诊断中的价值。方法对经我院确诊的70例变异性心绞痛患者进行常规12导联心电图和Marquette Holter心电监测仪检查,比较两种检测方法中ST段、T波、室性早搏等指标的变化,并对患者行冠状动脉造影(CAG),对其检测结果进行回顾性分析。结果冠状动脉造影检查示冠状动脉无明显病变10例,轻度狭窄15例,中度狭窄37例,重度狭窄8例,而且阵发性ST段抬高的高度、持续时间与冠脉狭窄的程度呈正相关。同时常规心电图对变异性心绞痛的检测率明显低于动态心电图,两者相比差异有统计学意义(P<0.05)。结论动态心电图准确完整地记录变异性心绞痛发作的全过程,对诊断变异性心绞痛具有重要的临床应用价值。

Objective To investigate the variability of the dynamic electrocardiogram in the diagnosis of variant angina pectoris.Methods Seventy cases of variant angina pectoris were examined with normal 12-lead ECG and Marquette Holter ECG.To compare the change of the ST segment,T wave,ventricular premature beats and other indicators with the two methods.All patients underwent coronary angiography（CAG） and its test results were analyzed retrospectively.Results Dynamic coronary angiography showed no significant degree of coronary artery disease in 10 cases,15 cases of mild stenosis,moderate stenosis of 37 cases,8 cases of severe stenosis,and paroxysmal ST elevation height,duration and extent of coronary artery stenosis was positively correlated.At the same time ECG detection of variant angina pectoris was significantly lower than the dynamic ECG,the difference was significant（P0.05）.Conclusion Dynamic ECG accurate and complete record the whole process of variant angina attack,and has important clinical value in diagnosis of variant angina pectoris.