动态心电图对心肌缺血诊断价值的研究进展

Research Progress of Dynamic Electrocardiogram in Diagnosis of Myocardial Ischemia

心肌缺血是冠状动脉血流减少导致心肌供氧供血不足的一种病症,临床依据患者是否存在胸痛症状将该病划分为两个类别,即有症状性心肌缺血、无症状性心肌缺血。在既往研究资料中表明,冠心病心肌缺血患者中,25%左右为有症状者,75%左右为无症状者;而在稳定性心绞痛患者中,无症状性心肌缺血者的占比区间为20%~60%;以此导致很多患者发病后,因不具备典型症状而大概率误诊、漏诊。现阶段临床多通过冠脉CT、冠脉造影、核素心肌灌注显像以及心电图运动平板试验等方式对心肌缺血进行诊断,但这些技术存在有创性、体制运动能力要求等弊端,难以普及;动态心电图因不具备上述弊端,且诊断信息更为充足成为一种使用频率较高的心肌缺血诊断方案。本文结合既往研究资料对动态心电图诊断心肌缺血的价值进行分析,旨在可以为相关人员提供参考。

Myocardial ischemia is a condition in which the reduction of coronary blood flow leads to insufficient oxygen and blood supply to the myocardium.Clinically,the disease is divided into two categories based on whether the patient has chest pain symptoms,namely,symptomatic myocardial ischemia and asymptomatic myocardium Ischemia.According to previous research data,among patients with coronary heart disease myocardial ischemia,about 25%are symptomatic and about 75%are asymptomatic;and among patients with stable angina pectoris,the proportion of asymptomatic myocardial ischemia is in the range 20%~60%;this leads to a high probability of misdiagnosis and missed diagnosis because many patients do not have typical symptoms after the onset.At this stage,the clinical diagnosis of myocardial ischemia is mostly through coronary CT,coronary angiography,radionuclide myocardial perfusion imaging,and electrocardiogram exercise treadmill test.However,these technologies have disadvantages such as invasiveness and systemic exercise requirements,which are difficult to popularize.Holter does not have the above-mentioned drawbacks and has more sufficient diagnostic information to become a more frequently used diagnostic program for myocardial ischemia.This article combines previous research data to analyze the value of Holter in the diagnosis of myocardial ischemia,and aims to provide reference for relevant personnel.