动态心电图各指标与冠心病及其严重程度关系的探讨

Study on the correlation about ambulatory electrocardiography and coronary heart disease and its extend

目的 分析动态心电图 (AECG)各指标与冠状动脉病变及其严重程度的关系。方法 选择 12 6例同期行冠状动脉造影 (CAG)和 2 4hAECG监测的患者 ,按CAG结果分组 ,对AECG所获得的各项指标进行统计学分析和比较。结果 ①病变组与对照组在最慢心率、最快心率、ST段压低程度、ST/HR、T波变化指标上两组间比较差异有显著意义 (P <0 0 1) ,而在各种类型的心律失常、平均心率指标上差异无显著意义 (P>0 .0 5 )。②单支、双支、三支病变组间比较 ,平均心率、最慢心率及ST、ST/HR指标上差异有显著意义 (P <0 0 1) ;室早 (VE)、成对室早 (VE Pair)、室速 (VT)的数量虽有递增趋势 ,但三组之间差异无显著意义 (P >0 0 5 )。③多元Logistic回归及多元线性回归分析显示 :ST、ST/HR与冠脉病变范围及程度呈正相关。结论 ①ST、ST/HR指标与冠脉病变范围及程度呈正相关 ,可以反映冠心病及其病变严重程度。②AECG中心律失常类型及数量均不能作为冠心病的诊断指标。

Objective To study the correlation about ambulatory electrocardiography and coronary pathology and its extend.Methods We selected 126 patients who had undergone 24h ambulatory electrocardiography(AECG) and selective coronary angiography(CAG) in the same period.The groups were divided according to the results of CAG.Then we analyzed and compared the data of AECG between two groups[CAG(+) and CAG(-)].Results (1)Statistic significance was found in the variables of minimum heart rate,maximum heart rate,ST depression,ST/HR and T wave change between the groups of CAG(+) and CAG(-)(P<0.01).No statistic significance was found in the variables of mean heart rate and arrhythmia(P>0.05).(2)Statistic significance was found in the variables of mean heart rate,minimum heart rate,ST and ST/HR among the three groups of single,double and triplet coronary disease(P<0.01).In the variables of arrhythmia,although the numbers of VE,VE-Pair and VT were increased,there was no statistic significance be found.(3)Analyses of multiple logistic regression and multiple linear regression had shown that positive correlation was found between the variables of ST,ST/HR and the extend of coronary disease.Conclusion (1)There is positive correlation between the variables of ST,ST/HR and the extend of coronary disease.ST and ST/HR are the reliable variables of reflecting myocardial ischemia and the extend of coronary disease.(2)Neither the type nor the number of arrhythmia is regard as the diagnostic variable for coronary heart disease.