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目的:研究动态心电图对无症状性心肌缺血的临床诊断价值。方法:收集我院2014年6月-2015年6月我院接受诊治的冠心病(CAD)患者120例作为研究对象,采用动态心电图仪检测记录24h心电图信息,将动态心电图检测为心肌缺血的患者分为A组(无症状心肌缺血)、B组(有症状心肌缺血),比较两组患者基本信息、心肌缺血发作阵次、ST段下降幅度、ST段下降持续时间、心肌缺血阈变异性、心率及心率失常发生率。结果:120例CAD患者中有95例患者出现心肌缺血,其中A组66例(占69.47%),B组29例(占30.53%),差异显著(P<0.05)。A组ST段阵次改变明显高于B组,A组ST段下降幅度、ST段下降持续时间、心肌缺血阈变异性明显低于B组(P<0.05)。A、B两组患者心肌缺血发作表现出昼夜节律,在时间段6:00-12:00最高,在时间段0:00-6:00最低(P<0.05)。A组患者平均心率显著低于B组患者,心律失常发生率显著高于B组(P<0.05)。结论:动态心电图能够准确的诊断出无临床症状心肌缺血,使患者得到及时的治疗,值得临床推广应用。
Objective: To study the value of dynamic electrocardiogram in the clinical diagnosis of asymptomatic myocardial ischemia. Methods: A total of 120 patients with coronary heart disease (CAD) receiving our hospital from June 2014 to June 2015 in our hospital were collected. The electrocardiogram (ECG) data were recorded by dynamic electrocardiography (ECG), and myocardial electrocardiogram The patients were divided into group A (asymptomatic myocardial ischemia) and group B (symptomatic myocardial ischemia). The basic information of two groups were compared. The number of myocardial ischemic attack, the decrease of ST segment, the duration of ST segment depression, Blood Threshold Variability, Heart Rate and Arrhythmia Rates. Results: Myocardial ischemia occurred in 95 of the 120 CAD patients, including 66 cases in group A (69.47%) and 29 cases in group B (30.53%), with significant difference (P <0.05). The change of ST segment in group A was significantly higher than that in group B. The decrease in ST segment, the decrease in ST segment and the threshold of myocardial ischemia in group A were significantly lower than those in group B (P <0.05). The myocardial ischemia in patients A and B showed circadian rhythm, which was the highest at 6: 00-12: 00 and the lowest at 0: 00-6: 00 (P <0.05). The average heart rate in group A was significantly lower than that in group B, and the incidence of arrhythmia was significantly higher than that in group B (P <0.05). Conclusion: Holter can accurately diagnose myocardial ischemia without clinical symptoms, so that patients receive timely treatment, worthy of clinical application.