62例变异性心绞痛患者动态心电图分析

Dynamic electrocardiography analysis of variant angina patients

[目的]探讨12导联动态心电图(DCG)对变异性心绞痛患者监测的临床价值。[方法]回顾性分析62例临床诊断为变异性心绞痛患者的DCG监测结果及临床资料,观察发作时ST-T改变与症状关系;心绞痛发作时间;ST段抬高(痉挛部位)与冠状动脉造影结果的相关性;病变部位、ST段抬高幅度、持续时间与相关心律失常性质的关系。[结果]ST-T改变与胸痛发作时间基本一致;心绞痛多发生在凌晨、夜间(70%);ST段抬高导联提示的痉挛部位与冠状动脉造影的狭窄部位有关;心律失常的性质与痉挛部位密切相关;多部位病变者心律失常发生率明显增高;ST段抬高≥4 mm心律失常发生率较ST段抬高<4 mm明显增高(P<0.05);疼痛持续时间≥3 min心律失常发生率较疼痛持续时间<3 min明显增高(P<0.05)。[结论]DCG能够完整准确记录变异性心绞痛发作的全过程,还能对心肌缺血损伤部位加以定位诊断,对提高变异性心绞痛诊断有重要的临床应用价值。

[Objective] To explore the clinical monitoring value of 12-lead Dynamic Electrocardiography（DCG） in variant angina patients.[Methods] We retrospectively analyzed the monitoring results and clinical data of 62 variant angina patients.The correlations between the change of ST-T and symptom attacked,the duration of symptom with angina pectoris were observed.And the correlations between ST segment elevation（spastic sites）and the results of coronary angiography,the value of ST segment elevation,and the quantity of related arrhythmia were also analyzed.[Results] We found that the change of ST-T was consistent with attack time of chest pain,and the angina pectoris usually occurred in the morning and at night（70%）.The spastic site detected from the DCG were conceited with the stenosis site in coronary angiography,and the incidence ratio were obviously higher in the patients with ST elevation≥4 mm than those with ST elevation4 mm（P〈0.05）;The arrhythmia were obviously higher in the patients with the duration≥3 min than those with the duration3 min（P〈0.05）.[Conclusion] DCG can exactly record the overall process of variant angina attack,and it also can locate the ischemic coronary.DCG plays an important role in the diagnosis of variant angina.