动态心电图评价无症状性心肌缺血的价值

目的 探讨动态心电图（DCG）评价无症状性心肌缺血（SMI）的临床意义.方法 采用12导联DCG对2009年1月-2010年1月间在我院诊疗的冠心病患者60例进行检测,分析检测结果.结果 60例冠心病者检出缺血型ST-T变化者53例（88.33%）,共155阵次.属SMI者115阵次（74.19%）,有症状40阵次（25.81%）.115阵次SMI中66阵次（57.39%）与轻微的体力劳动或脑力活动因素有关,49阵次在安静时出现（42.61%）.115阵次SMI中在6：00～12：00发生者占42.61%,0：00～6：00发生者占12.17%,两者比较,差异具有统计学意义（P〈0.05）. SMI患者的ST段压低幅度、缺血持续时间与有症状心肌缺血患者比较差异无统计学意义（P〉0.05）.结论 动态心电图评价无症状性心肌缺血的临床意义重大,值得应用.

Value of dynamic electrocardiogram for assessing silent myocardial ischemia

Objective To explore the value of dynamic electrocardiogram ( DCG ) for assessing silent myocardial ischemia ( SMI ). Methods 60 patients with coronary artery diseases in our hospital from January 2009 to January 2010 were detected by DCG and the findings were analyzed. Results 53 of the 60 patients ( 88.33% ) had ST-T segment alteration, with 155 episodes. 115 ( 74.19% ) episodes occurred in those with SMI and 40 ( 25.81% ) in symptomatic patients. 66 ( 57.39% ) episodes of ST-T alteration were associated with slight physical labor and brain activity and 49 ( 42.61% )episodes developed at rest. 42.61% of SMI occurred from 6:00 to 12:00 and 12.17% from 0:00 to 6:00, and there was a significant difference ( P<0.05 ). The degree of ST-T depression and duration of ischemia did not differ significantly between the patients with SMI and those with symptons ( P> 0.05 ). Conclusions It is of great significance to dynamic electrocardiogram in the asseseement of silent myocardial ischemia and the procedure is worth being used widely.