12导联动态心电图对无症状性心肌缺血的诊断价值

目的探讨12导联动态心电图(ambulatory electrocardiogram,AECG)对无症状性心肌缺血(silent myocardial ischemia,SMI)的诊断价值。方法回顾性分析316例确诊的冠心病患者AECG检测结果。结果①AECG中ST段压低检出率高于常规心电图,差异有统计学意义(P<0.05);②无症状性心肌缺血时ST段压低持续时间在06:00～12:00时段最长,差异有统计学意义(P<0.05);③无症状性心肌缺血发作多呈快频率依赖性,与慢频率依赖性相比,差异有统计学意义(P<0.05)。结论 12导联动态心电图可以明确无症状性心肌缺血患者发作次数、持续时间及演变规律,为临床心肌缺血诊断及预后观察提供重要依据。

The diagnostic value of 12 lead ambulatory electrocardiogram for silent myocardial ischemia

Objective To investigate the diagnostic value of 12 lead ambulatory electrocardiogram(AECG)for silent myocardial ischemia(SMI).Methods AECGs of 316 patients diagnosed with coronary heart disease were analyzed retrospectively.Results ① The detection rate of ST-segment depression by AECG was higher than that of electrocardiogram(ECG),and the difference was statistically significant(P<0.05).② The duration of ST-segment depression in SMI was the longest during 06:00-12:00,and the difference was statistically significant(P<0.05).③ The attack of SMI was fast frequency-dependent,and comparing with the slow frequency-dependent SMI,the difference was statistically significant(P<0.05).Conclusion Twelve lead AECG could be used to confirm the frequency,duration and evolution law of silent myocardial ischemia and provides an important basis for clinical diagnosis and prognostic observation of the disease.