动态心电图夜间ST-T改变的临床意义

Diagnostic value and clinical significance of nocturnal ST-T changes in dynamic electrocardiogram

目的:探讨24h动态心电图夜间ST-T改变诊断冠心病的价值及其临床意义。方法:选择103例24h动态心电图有ST-T改变的患者行选择性冠状动脉造影术,其中56例有间歇性夜间显著ST-T改变的患者为研究组,47例有持续性ST-T改变的患者为对照组,对其结果进行分析。结果:与对照组比较,研究组冠状动脉造影阳性率显著升高(31.9%比67.9%),胸闷、胸痛(27.7%比66.1%),高血压(48.9%比71.4%),高脂血症(31.9%比42.9%),糖尿病(17.0%比46.4%)的发生率及左前降支(LAD,21.3%比57.1%)、左回旋支(LCX,14.8%比37.5%)、右冠状动脉(RCA,12.8%比35.7%)病变比例明显增大(P<0.05或<0.01)。结论:24h动态心电图中夜间ST-T显著改变诊断冠心病价值较大,可以作为诊断心肌缺血的一个较敏感指标。

Objective：To explore diagnostic value of nocturnal ST-T changes in 24h dynamic electrocardiogram （DCG）for coronary heart disease （CHD）and its clinical significance.Methods：A total of 103 cases,who showed ST-T changes in 24h DCG,received selective coronary angiography （CAG）.Among them,the 56 patients with in-termittent nighttime significant ST-T changes were regarded as research group,while the other 47 patients with per-sistent ST-T changes were treated as control group.CAG results were compared and analyzed between two groups. Results：Compared with control group,there were significant rise in CAG positive rate （31.9% vs.67.9%）,inci-dence rates of dyspnea and chest pain （27.7% vs.66.1%）,hypertension （48.9% vs.71.4%）,hyperlipidemia （31.9% vs.42.9%）and diabetes mellitus （17.0% vs.46.4%）,percentages of lesions in left anterior descending artery （LAD,21.3% vs.57.1%）,left circumflex coronary artery （LCX,14.8% vs.37.5%）and right coronary artery （RCA,12.8% vs.35.7%）in research group,P 〈0.05 or 〈0.01. Conclusion：Nocturnal ST-T signifieantly changes in 24h DCG,it possesses more diagnostic value for CHD,which can be regarded as a more sensitive index diagnosing myocardial ischemia.