变异型心绞痛患者66例12导联同步动态心电图分析

目的探讨动态心电图对变异型心绞痛患者的诊断价值。方法对66例变异型心绞痛患者应用常规心电图(ECG)、24 h动态心电图(DCG)检测,对两种方法进行比较。同时应用DCG分析心绞痛发作次数和时间。结果损伤型ST段抬高(0.2~1.2 mV)伴对应导联ST段下移,T波高耸对应导联T波倒置或低平,室性期前收缩,加速性室性逸搏,房室传导阻滞,巨型R波,U波倒置检出率DCG为25.8%、72.7%、54.5%、36.4%、40.9%、22.7%、10.6%;ECG检出率为3.0%、7.6%、4.5%、1.5%、3.0%、1.5%、1.5%;两者比较有非常显著性差异(P<0.05)。心电图异常发作高峰时间在00∶00~08∶00。结论 DCG能够表现变异型心绞痛的全过程,对提高VAP的诊断率具有重要价值。

Analysis of 12-lead synchronous dynamic electrocardiogram in 66 patients with variant angina

Objective To investigate the diagnostic value of dynamic electrocardiogram（ECG） in patients with variant angina.Methods Conventional ECG and 24h Holter test were performed and the results were compared in 66 patients with variant angina.The frequency and duration of angina pectoris were determined according to the analysis of the dynamic ECG.Results The abnormal ECG findings in the patients included the injury-type ST-segment elevation（0.2~1.2 mV） with the corresponding ST-segment depression,T-wave inversion or flattening in high-amplitude T wave corresponding lead,ventricular premature contraction,accelerated idioventricular rhythm,atrioventricular conduction block,giant R-wave,and U wave inversion.The detection rates of these abnormal ECG patterns were 25.8%,72.7%,54.5%,36.4%,40.9%,22.7%,and 10.6% respectively in dynamic ECG;whereas they were 3.0%,7.6%,4.5%,1.5%,3.0%,1.5%and 1.5% respectively in conventional ECG.There was a significant difference（P0.05） in the detection rate of the above abnormalities between ECG and dynamic ECG.The peak time period for the onset of variant angina was 00：00～08：00 pm.Conclusion Dynamic ECG can show the whole process of variant angina,therefore it is of great value for improving the diagnostic rate of variant angina.Frequent onset of variant angina indicates poor prognosis,malignant arrhythmia and even sudden death may occur.