糖尿病患者无症状性心肌缺血的临床研究

目的探讨如何对无症状性心肌缺血的糖尿病患者进行及时诊断。方法对382例糖尿病患者进行24h动态心电图监测,根据ST段压低情况及其与临床症状、发作时间、持续时间、心率变化及日常活动的关系做定性、定量分析。结果检出109例（28.5%）ST段压低,其中单纯性无症状性心肌缺血73例,无症状缺血型ST段压低发生的次数是有症状的4.1倍;心肌缺血发作时,症状的有无与缺血时间长短无关;无症状心肌缺血多见于一般活动中（43.1%）,发作时与发作前心率比较差别不大,发作高峰在06：00-12：00。结论心电图表现为心肌缺血的糖尿病患者,有一部分患者无胸痛或与心肌缺血相关的主观症状。

Asymptomatic myocardial ischemia in diabetic patients

Objective To discuss how to diagnose and prevent asymptomatic myocardial iscbemia in dia- betic patients. Methods The data of 382 diabetic patients who had 24 - hour ambulatory ECG were analyzed. The relation between the ST - segment depression and when the symptoms happened, how long it continued, the change of heart rate and daily activity was recorded. Results There are 109 patients （ 28.5% ） whose ST - segment de- pressed. Among them, 73 patients had asymptomatie myocardial isebemia simplely, and the asymptomatic myocar- dial iscbemia patients is 4.1 times more than patients who have symptoms on attack views. When the myocardial is- ehemia attacked, the symptoms had no relation to how long it continued. The asymptomatic myocardial iscbemia at- tacks in daily activity particularly （ 43.1% ）. The change of heart rate when attack had no differences from that be- fore attacked, and the peak time of attacked was 6：00 -12：00. Conclusion Some diabetic patients who happen myocardial isehemia have no chest pain or other symptoms caused by myocardial iscbemia.