动态心电图对冠心病无症状性心肌缺血的临床诊断价值

目的探讨动态心电图对冠心病无症状性心肌缺血的临床诊断价值。方法选择本院2015年1月~2017年1月期间收治的冠心病患者140例,为患者提供动态心电图检查,持续时间1 d,随后经过回放的形式分析结果中ST段位移的变化情况。结果 140例冠心病患者127例出现心肌缺血,占90.7%,心肌缺血次数423次,包括有症状性心肌缺血68次,占16.1%,两组数据对比存在统计学差异(P0.05)。患者在早晨8点到晚上6点的ST下移为(0.18±0.04)m V,下移的持续时间为(3.23±2.11)min,心肌缺血阈变异性为(24.95±1.41)%,患者晚上6点到次日早晨6点的ST下移(0.13±0.02)m V,下移持续时间为(6.16±3.32)min,心肌缺血阈变异性为(27.17±1.90)%,对比存在统计学差异(P0.05)。患者心肌缺血发作前的心率为(90.3±12.0)次/min,心肌缺血发作后的心率为(70.4±7.0)次/min(P0.05),患者心肌缺血发作前ST下移(0.18±0.02)m V,心肌缺血发作后ST下移(0.07±0.01)m V(P0.05)。结论动态心电图用于冠心病无症状性心肌缺血疾病的诊断具有重要作用,为冠心病患者病情的掌握及后续回访、治疗等提供有利的参考依据。

Clinical diagnostic value of dynamic electrocardiogram in asymptomatic myocardial ischemia in patients with coronary heart disease

Objective To evaluate the clinical diagnostic value of dynamic electrocardiogram(ECG)in asymptomatic myocardial ischemia in patients with coronary heart disease.Methods 140 patients with coronary heart disease who were admitted to our hospital from January 2015 to January 2017 were selected.The patients were given dynamic ECG examination,with the duration of 1 d.The changes in ST segment displacement were analyzed afterwards in the form of replay.Results Among 140 patients with coronary heart disease,127 patients showed myocardial ischemia,accounting for 90.7%.The number of myocardial ischemia was 423 times,including 86 times of symptomatic myocardial ischemia,accounting for 16.1%.There was statistically significant difference between the two groups(P<0.05).The ST moved down by(0.18±0.04)mV from 8 am to 6 pm in the patients.The duration of moving down was(3.23±2.11)min,and the variability of myocardial ischemia threshold was(24.95±1.41)%.The ST moved down by(0.13±0.02)mV from 6 pm to 6 am in the next morning.The duration of moving down was(6.16±3.32)min,and the variability of myocardial ischemia threshold was(27.17±1.90)%.There was statistically significant difference between the three groups(P<0.05).The heart rate was(90.3±12.0)times/min before myocardial ischemic attack,and the heart rate after myocardial ischemic attack was(70.4±7.0)times/min(P<0.05).The ST moved down by(0.18±0.02)mV before myocardial ischemic attack,and ST moved down by(0.07±0.01)mV after myocardial ischemic attack(P<0.05).Conclusion Dynamic electrocardiogram(ECG)has an important role in the diagnosis of asymptomatic myocardial ischemic disease in coronary heart disease,which provides a favorable reference for mastering disease conditions,subsequent visit and treatment for the patients with coronary heart disease.