摘要
目的 :探讨老年冠心病患者无症状性心肌缺血 (SMI)的临床特点和发生规律。方法 :对 2 5 6例老年冠心病患者行 2 4 h动态心电图检测 ,检出心肌缺血 16 7例 ,按临床情况分为 3组 : 组 :单纯 SMI; 组 :有心绞痛史的患者 ; 组 :心肌梗死后患者。结果 :SMI的发生明显高于有症状性心肌缺血 ,占 84 .3% ,发作时间主要是白天 ,以上午 6～ 12点发作最频 ,0～ 6点最少。 , , 组的心肌缺血程度 (SMI发作次数 ,缺血持续时间 ,ST段压低幅度 )及室性心律失常发生率依次增加 ,而 SDNN和 HRVI依次递减。结果表明 ,心肌缺血程度与室早发生率呈正相关 ,与SDNN,r MSSD,PMN50 及 HRVI呈负相关。结论 :SMI是老年冠心病最常见的表现形式 ,应引起足够重视。
AIM: To study the clinical feature of silent myocardial ischemia(SMI) in aged patients with coronary heart disease(CHD). METHODS: 24 hour dynamic electrocardiographic monitoring was performed in 256 aged patients ,myocardial ischemia was found to occur in 167 patients. The 167 patients were divided into three groups: Ⅰ group: pure SMI;Ⅱ group:patients with angina pectoris; Ⅲ group: patients after myocardial infarction. RESULTS: The frequency of occurrence of SMI (84.3%) was much higher than symptomatic ischemia, which mainly occured in day time. The frequency of SMI was highest between 6 a.m to 12 a.m and was lowest between 0 a.m to 6 a.m. The extension of myocardial ischemia (frequency and duration of episodes of SMI, the extension of ST segment depression) and the incidence rate of ventricular arrhythmia increased gradually, while SDNN and HRVI decreased gradually in SMI Ⅰ , Ⅱ and Ⅲ groups. The extension of ischemia had positive correlation with the incidence rate of ventricular arrhythmia, while negative correlation with SDNN, rMSSD, PMN 50 and HRVI. CONCLUSION: SMI is the most common manifestation in aged patients with CHD, which should be paid more attention to. The impairment of cardiac autonomic nerves is associated with the extension of ischemia in patients with CHD.
出处
《心脏杂志》
CAS
2002年第5期390-392,共3页
Chinese Heart Journal
