24 h动态心电图检测冠心病无症状心肌缺血阈的临床分析

目的探讨动态心电图对冠状动脉粥样硬化性心脏病（冠心痛）病人无症状心肌缺血闽值的临床意义。方法53例冠心病病人24h心电图检测其心肌缺血闽值、心肌缺血闽值的变异度、每阵缺血发作持续时间和ST段最大位移，以及昼夜缺血次数。结果共检出468例缺血发作，以心率加快时心肌缺血居多，达91．2％，夜间心肌缺血闽值较低，且缺血持续时间及ST段压低程度明显长于厦重于白昼。心肌缺血阈的变异度为22．3％。与缺血总阵数呈正相关。结论高心肌缺血阈与心肌耗氧量有关，低心肌缺血闽与冠状动脉张力有关。

Threshold of Myocardial Ischemia by Ambulatory Electrocardiogram

Objective To evaluate clinical significance of silence myocardial ischemic threshold by ambulatory electrocardiogram.Methods Fifty-three cases with coronary disease were investigated by 24 hour ambulatory electrocardiogram.The myocardial ischemic threshold,variability of myocardial ischemic threshold,and duration of ischemic episodes were observed.Results There were 91.2% fast heart rate and ST depression among 468 ischemic episodes and noctural ischemias had lower threshold longer mean ischemic time as well as deeper ST depression.It is 22.3% that the variability of the myocardial ischemia was 22.5%.Conclusion The results suggested the nigher the myocavdial ischemic threshold,the more myocardial oxyen consumption.