动态心电图对病变冠脉及狭窄程度的预测

12-lead Holter for the prediction of coronary lesion andcoronary stenosis

目的 评价 12导动态心电图 (12导Holter)对冠心病 (CHD)患者病变冠脉及狭窄程度的诊断价值。方法 选择 87例拟诊为冠心病的住院患者 ,同期内 (间隔 <1周 )分别接受冠状动脉造影 (CAG)和 12导Holter检查 ,以CAG作为对照 ,对 12导HolterST段结果进行分析。结果 ①单支组ST段压低幅度、持续时间在冠脉狭窄≥ 75 %组较冠脉狭窄 5 0 %～ 74 %组增大 ,两组间比较有统计学意义。②单支组LAD病变 16例 ,ST段压低表现在V4～V65例 ,ⅡⅢavFV5V611例 ;RCA病变 8例 ,ST段压低表现在ⅡⅢavF 1例 ,ⅡⅢavFV5V67例 ;LCX病变 1例 ,ST段压低表现在V5V6。结论 根据ST段压低出现导联、压低幅度和持续时间 。

Objective To evaluate the diagnostic value of 12-lead Holter in coronary lesion and degree of coronary stenosis. Methods Eighty-seven patients wereexamined by coronary angiography (CAG) and 12-lead Holter.The duration of bothmethods was less than one week. Based on CAG, ST-segment data of 12-lead Holter were compared with CAG. Results ①In the single vessel group,the rangeof ST segment depression and the continual time in ≥75% coronary stenosis group were more than those in 50%～74% coronary stenosis group. There was significant difference between the two groups(P<0.05). ②In the single vessel group ,there were 16 patients suffered from LAD,8 patients from RCA and one patient from LCX. Among 16 patients ,there were 5 ST depression at lead of V 4～V 6 and 11 at ⅡⅢavF.Among 8 patients,there was one at lead of ⅡⅢavF and 7 at ⅡⅢavFV 5V 6.The ST segment depression of one CHD patient from LCX was at lead of V 5V 6. Conclusion The lead of ST-segment depression ,the range of ST-segment depression and the continual time can preliminary forecast and assess thecoronary lesion and the degree of coronary stenosis.