动态心电图与常规心电图诊断无症状心肌缺血对比观察

Clinical diagnosis on contrast of conventional and dynamic ECG for asymptomatic myocardial ischemia

目的 对比分析24小时动态心电图（Holter）与常规心电图诊断无症状心肌缺血（SMI）效果的差异性.方法 选择2009年3月至2012年3月心内科接诊的80例符合SMI诊断标准的冠心病患者.按照随机数表法,分为实验组和对照组两组,每组各40例患者.实验组采用动态心电图对患者进行诊断,对照组采用常规心电图对患者进行诊断.诊断后,对两组患者SMI阳性检出率进行比较分析,并对实验组患者的阳性反应进行观察记录.结果 研究发现,实验组患者的SMI阳性检出率（92.5％）明显高于对照组（72.5％）,两组比较差异有统计学意义（P＜0.05）.实验组患者在阳性反应发作时,会出现规律性的活动,发作时间也有一定的规律.结论 采用Holter可连续记录受检者24～48小时的心电变化,记录仪轻巧,检查期间受检者随身携带而不影响其日常生活与工作,尤其对SMI诊断的效果明显优于常规心电图检查.

Objective To compare and analyze the differences of diagnosis effects of 24h conventional and dynamic ECG （Holter） to asymptomatic myocardial ischemia.Methods 80 patients from March 2009 to March 2012 in our department of cardiology with asymptomatic myocardial ischemia and coronary heart disease were studied.According to the random number table method,they were divided into experimental group and control group,40 patients in each group.The experimental group used dynamic ECG diagnosis while patients in the control group were given conventional ECG diagnosis.After diagnosis,a comparative analysis of the two groups with asymptomatic myocardial ischemia positive rate was carried out,and the experimental group patients with positive reactions were observed and recorded.Results The study found that positive rate of the experimental group was 92.5%,significantly higher （72.5%） than that in control group,differences in two groups were statistically significant （P〈0.05）.When experimental group was with the onset of the positive reaction,there were regular activities and certain rules in the onset time.Conclusion Continuous 24h ambulatory ECG （Holter） can record subjects with 24-48 hour of ECG changes,the lightweight recorder can be carried during the inspection period without affecting daily life and work,it has obvious effects especially for asymptomatic myocardial ischemia.And its diagnosis is better than that of the conventional ECG.