摘要
本文对３６例临床确诊为冠心病患者进行２４ｈ动态心电图（ＤＣＧ）检查，并与９９ｍＴＣ－ＭＩＢＩ心肌灌注断层显影（心肌ＥＣＴ）、常规心电图（ＥＣＧ）及冠脉造影（ＣＡＧ）检查作对比分析。结果显示：ＤＣＧ发现心肌缺血２６例，检出率为７２．２％，较ＥＣＧ（１７例）的检出率（４７．２０％）高，经统计学处理，二者有显著差异（Ｐ＜０．０５）。心肌ＥＣＴ表现为放射性心肌缺损或稀疏者占３１例，检出率为８６．１％。３６例患者经ＣＡＧ检查，有３３例造影成功，其中冠脉狭窄≥５０％者２７例（８１．８％）。本文对２６例经ＤＣＧ检查发现有心肌缺血患者和ＣＡＧ检查结果作对比，显示ＤＣＧ所见的缺血范围和严重程度与ＣＡＧ所见病变的部位和受累程度，多数相符合；而与心肌ＥＣＴ作对比观察，提示有７３．０％患者，其ＤＣＧ缺血部位和心肌之放射性稀疏或缺损区所分布的部位也基本相似。因此，动态心电图检查对判断有否心肌缺血和估计冠脉病变部位及严重程度，可提供有价值的参考资料。
patients with coronary artery disease were assessed by 24 hour ambulatory electrocardiography(DCG) monitoring and comparatively studied with the examination of routine electrocardiography(ECG), 99m TC MIBI myocardial perfusion emission computed tomography(ECT) and coronary angiography(CAG). The results showed: 26 cases(72.2%) of the patients tested by DCG showed myocardial ischemia, the percentage was higher than that of the patients (the percentage was 47.2%) tested by ECG(P<0.05). Meanwhile 31 cases(86.1%) of the patients tested by ECT were found to have radioactive myocardial defect or sparse area. All of the 36 patients were examined by CAG, 33 of them had got successful examination, in 27 cases(81.8%) of these patients the degree of narrowing of coronary arteries was ≥50%. Through comparison, it was shown that the extent and degree of myocardial ischemia of patients tested by DCG was consistent with the area of pathological changes of coronary arteries examined by CAG in most patients. In about 73% of patients tested by DCG, the area of myocaridal ischemia was basically correspond to the radioactive myocardial defect or sparsity of patients tested by ECT. According to the above study, it is suggested that the assessment of DCG could provide useful data for determining the myocardial ischemia and estimating the area or degree of coronary pathological changes.
关键词
冠心病
动态心电图
放射性核素
冠状动脉造影
coronary disease
electrocardiography ambulatory
radionuclide angiography
coronary angiography
comparative study
