短暂心肌缺血过程中心室晚电位的动态变化

Dynamic Transformation of Ventricular Late Potential in the Period of Transient Myocardial Ischemia.

对 38例心肌梗死恢复期的病人 ,应用数字化Holter记录仪 2 4h连续监测心室晚电位 (VLP) ,以判定心肌短暂缺血对VLP的影响。Holter中加强ST段分析软件经人为定标后 ,自动分析记录达到缺血标准的时间及程度 ,其中2 1例在Holter分析中检测出一过性心肌缺血 ,此时VLP参数总QRS波持续时间 (TQRS)、QRS波末期幅度低于 4 0uV信号持续时间 (LAS40 )明显延长 (分别为 10 7.6± 14 .3vs 98.8± 12 .7ms,36 .5± 10 .8vs2 8.4± 9.5ms;P均 <0 .0 0 1) ,QRS波末期最后 4 0ms的均方根电压 (RMS40 )幅值显著减少 (2 8.9± 17.9vs 4 3.5± 2 0 .2uV)。缺血期VLP阳性 14例 ,缺血恢复 2h后VLP阳性 7例。结论 :心肌短暂缺血发作有VLP一过性阳性改变 。

Digital Holter ECG was recorded in 38 postinfarction patients to find out if transient myocardial ischemia could be identified by ventricular late potential(VLP).The Holter recorder can analyze automatically the time and degree of transient myocardial ischemia by strengthen ST segment software.The alteration of ST segment was detected in 21 patients,which was caused by transient myocardial ischemia.Signal averaged ECG parameters TQRS and LAS were delayed distinctly(107.6± 14.3 vs 98.8±12.7 ms;36.5±10.8 vs 28.4±9.5 ms; P <0.001) and electric tension of RMS 40 was decreased remarkably(28.9±17.9 vs 43.5± 20.2 uV ).There were 14 positive cases of VLP during transient myocardial ischemia and only 7 after this period.Conclusion:Transient myocardial ischemia lead to transient positive of VLP,this dynamical change of VLP can be supervised by Digital Holter ECG.