摘要
目的 :探讨无症状性心肌缺血 (SMI)的发病率、心肌缺血与心脏猝死 (SCD)的关系及防治措施。方法 :6 4例冠心病 (CHD)患者 ,应用动态心电图 (DCG)作 2 4h连续检测 ,依据心肌缺血时受检者有无心绞痛或相关症状 ,分为SMI组和有症状MI组 ,分析SMI的发生率、缺血发作的昼夜节律及心肌缺血与重要心律失常和SCD的关系。结果 :① 6 4例CHD检出有缺血性ST -T改变者 5 7例 (占 89.1%) ,其中SMI组 4 3例 (占 75 .4 %) ,有症状MI组 14例 (占 2 4 .6 %) ,两组比较有显著性差异 (u值 =5 .15 3,P <0 .0 0 1) ;② 5 7例心肌缺血发作共 10 84阵次 ,其中SMI组 936阵次 (占 86 .3%) ,有症状MI组 14 8阵次 (占 13.9%) ,SMI组显著高于有症状组 (u值 =9.976 ,P <0 .0 0 1) ;③对 5 7例CHD患者进行了为期2年的随访观察 ,发现SMI组中的 4例 (占 9.3%)发生SCD ,(其中 1例AMI发生SCD) ,均为严重心肌缺血患者。结论 :SMI患者多缺血严重 ,易触发重要心律失常而导致SCD ,预后不良 ,重视早期诊断和治疗极为重要。
Objective: In order to detect the prevalence of silent myocardial ischemia (SMI), its possible relation of sudden cardiac death (SCD), and the method of preventing and treatment. Methods: Use the Dynamic electrocardiaogram (DCG) monitoring on 64 patients with coronary heart disease (CHD), according to the receptor had or no chest pain or other anginal equivalent when ischemic change occour on the DCG, divided as asymptomatic and symptomatic groups, analysis of the incidence of SMI, the day and night rhythm of ischemic episode, and its possible relation to important arrhythmias and SCD. Results: ①fifty seven of 64 patients (89.1%) have ischemic ST-T change, in whom SMI 43 cases (75.4%), symptomatic 14 cases (24.6%), the SMI group was significantly greater compared to symptomatic group (u=5.153, P<0.001). ② 57 patients with ischemic change had 1084 episodes, 936 episodes (86.3%) of which were SMI group, 148 episodes (13.9%) were symptomatic group (u=9.976, P<0.001),③ Follow─up on 57 patients with CHD for 2 years showed, 4 patients (9.3%) occoured SCD (in which one case AMI), all of which had serious ischemia. Conclusion: most of patients with SMI had serious ischmia, may trigger important arrhythmia and possible lead to SCD. hence, it is very important to intensity early diagnosis and treatment.
出处
《河北医学》
CAS
2002年第9期777-780,共4页
Hebei Medicine
