动态心电图诊断心肌缺血的临床应用

Clinical application of dynamic electrocardiogram in diagnosis of myocardial ischemia

目的探讨动态心电图在诊断心肌缺血中的临床应用价值。方法 135例冠心病患者为研究对象,所有患者均行24 h动态心电图检查,对检查结果进行分析。结果 1本组135例冠心病患者中,心肌缺血的发生率为47.41%（64/135）,其中无症状性心肌缺血的发生率（64.06%）、心肌缺血阵次率（65.32%）均显著高于有症状性心肌缺血（35.94%、34.68%）（P〈0.05）;2无症状性心肌缺血和有症状性心肌缺血的发生时间段均以05：00~11：00为主,但前者高于后者（P〈0.05）;3心肌缺血主要发生于年龄≥60岁人群,且患者年龄越大,发生心肌缺血的几率也越大。结论动态心电图可以有效检出心肌缺血患者,特别是无症状性心肌缺血,且能记录其发生时间,为早期临床干预提供重要参考。

Objective To investigate the clinical application value of dynamic electrocardiogram in diagnosis of myocardial ischemia. Methods There were 135 patients with coronary heart disease as the study subjects. They all received 24 h dynamic electrocardiogram examination, and their examination results were analyzed. Results 1 In the 135 patients with coronary heart disease, the incidence of myocardial ischemia was 47.41%（64/135）. The incidence of asymptomatic myocardial ischemia（64.06%） and array rate of myocardial ischemia（65.32%） were all higher than those of symptomatic myocardial ischemia（35.94%, 34.68%）（P〈0.05）. 2 Occurrence times of asymptomatic myocardial ischemia and symptomatic myocardial ischemia were mainly as 05：00~11：00, while the later had higher incidence than the former（P〈0.05）. 3 Myocardial ischemia mainly occurred in old people aging ≥60 years old, and its incidence increased with the growing of ages in patients. Conclusion Dynamic electrocardiogram can effectively detect myocardial ischemia patients, especially those with asymptomatic myocardial ischemia. It can also record occurrence time of the disease, so as to provide important reference for early clinical intervention.