动态心电图对冠状动脉内支架植入术前后无症状心肌缺血的研究

本文对72例成功进行PTCA和冠状动脉内支架术治疗的冠心病患者进行动态心电图随访研究，分别于术前、术后1周、1个月、3个月、6个月、12个月进行动态心电图检查，其中41例术前检查至少有一次缺血性ST段压低，占56．9％，31例术前后均无阳性ST段改变，占43．1％，术前存在缺血性ST段压低者术后1周、1个月、3个月、6个月、12个月无症状心肌缺血的发作次数，持续时间，最大ST段压低的幅度各指标与术前相比均有显著降低（P均＜0．001）。无症状心肌缺血总负荷，劳力性心肌缺血负荷，自发性心肌缺血负荷，术后各阶段与术前相比也有明显降低（P＜0．05）。本文提示冠状动脉内支架植入术可显著降低冠心病患者近期及远期无症状心肌缺血的发生率及严重程度。

The Effects of Intracoronary Stent Implantation on Silent Myocardial Ischemia in Patients with Coronary Artery Disease

24 hours Holier ECG monitoring was done in 72 patients who accepted successfully intracoronary stems implantation,41 of them showed silent myocardial ischemia before coronary stems implantation (56.9%). Holier ECG was monitored before stent implantation, at one week, one month, three months, six months and one year after stent implantation respectively. The results showed: (1) The frequency,the duration and the maximal ST-segment depression of the silent myocardial ischemic were significantly decreased after stems implantation compared with that before stems implantation (P<0. 001).Silent myocardial ischemic burden,the ischemic burden in effort and at rest was also significantly reduced at different stage after stems implantation compared with that before stems implantation (P<0.05). We concluded that intracoronary stems implantation can significantly improve the silent myocardial ischemia,Holier ECG monitoring can be used for evaluating the silent myocardial ischemia after intracoronary stent implantation.