心肌桥心肌缺血病人应用12导联动态心电图对心肌缺血与预后情况的评估价值

Value of 12 lead synchronous ambulatory electrocardiogram in evaluating myocardial ischemia and prognosis in patients with myocardial bridge myocardial ischemia

目的 分析心肌桥心肌缺血患者应用12导联动态心电图对心肌缺血情况与预后情况的分析。方法 选择2015年1月至2019年6月收治的124例心肌桥心肌缺血患者,行12导联动态心电图检查,记录患者心肌缺血情况以及预后情况。结果 在124例患者中,冠状动脉造影诊断为单支病变(单支病变组)57例,多支病变(多支病变组)67例。12导联动态心电图判断为心肌缺血者105例,心肌缺血检出率为85.2%。与单支病变组相比较,多支病变组的心肌缺血检出率、发作次数、总持续时间与ST段压低幅度更高(P<0.05)。12导联动态心电图判断为浅表型心肌桥96例,深在型心肌桥38例;心肌桥长度为(19.26±3.76)mm,心肌桥狭窄程度为(62.57±9.43)%,同时多支病变组与单支病变组心肌桥情况比较差异有统计学意义(P<0.05)。结论 12导联动态心电图可以较直观准确地评价心肌桥患者的心肌缺血状况,且12导联动态心电图也具有无创性及安全性高等特点。

Objective To investigate the application of 12 lead synchronous ambulatory electrocardiogram(Holter)in myocardial ischemia of myocardial bridge.Methods A total of 124 patients with myocardial bridge myocardial ischemia from January 2015 to June 2019 were selected as study objects.12 lead Holter was performed to record myocardial ischemia and prognosis.Results Among the 124 patients,57 patients were diagnosed as single vessel disease(single lesion group)and 67 patients were multi vessel disease(multiple lesions group).The detection rate of myocardial ischemia was 85.2%.Compared with single vessel disease group,the detection rate,attack times,total duration and ST segment depression were higher in multi vessel group(P<0.05).The 12 lead Holter results showed that 96 cases of superficial myocardial bridge,38 were deep myocardial bridge.The length of myocardial bridge was(19.26±3.76)mm,and the degree of myocardial bridge stenosis was(62.57±9.43)%.At the same time,there was significant difference between multiple lesions group and single disease group(P<0.05).Conclusion 12 lead Holter could evaluate myocardial ischemia of myocardial bridge patients directly and accurately,and 12 lead Holter has the characteristics of noninvasive and high safety.