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|本期目录/Table of Contents|

动态心电图对冠心病的诊断价值与核素心肌断层显影及冠脉造影的对比(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
1996年第4期
页码:
207-210
栏目:
论著
出版日期:
1996-08-01

文章信息/Info

Title:
he value of ambulatory electrocardiography monitoring in the diagnosis of coronary artery disease: Comparative study with radionuclide angiography and coronary angiography
作者:
李维绥　郑 勇　林 明　蔡洪斌
福建医科大学附属第一医院心内科　福州　350005
Author(s):
Li Weisui;  Zheng Yong ;  Lin Ming ;  Cai Hongbin
Cardiovascular Department, the 1st Affiliated Hospital, Fujian Medical University, Fuzhou 350005
关键词:
冠状动脉疾病;  心电描记术;  便携式;  放射性核素血管造影术;  冠状动脉造影;  对比研究
Keywords:
coronary disease;  electrocardiography ambulatory;  radionuclide angiography;  coronary angiography;  comparative study
分类号:
-
DOI:
-
文献标识码:
-
摘要:
本文对36例临床确诊为冠心病患者进行24 h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, 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查结果作对比, 显示DCG所见的缺血范围和严重程度与CA G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。
Abstract:
36 patients with coronary artery disease were assessed by 24-hour ambulatory electrocardiography (DCG) monitoring and comparatively studied with the examination of routine elect rocardiography (ECG) , 99mTC-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 mmyocardial defect or sparsity of patients tested by ECT. According to the above study, it is suggested that the assessment of DCG coul provide useful data for determuning the myocardial ischemia and estimating the area or degree of coronary pathological changes.

参考文献/References

［1］Deedwania PC, Carbajal EV. Silent myocardial ischemia during daily life is an independent predictor of mortality in stable angina. Circulation 1990; 81: 748.

［2］ 潘中允, 主编. 临床核医学. 北京: 原子能出版社, 1994: 189.

［3］刘秀杰, 马寄晓, 主编. 临床心肺核医学. 北京: 北京医科大学中国协和医科大学联合出版社1993: 233.

［4］吴 遐, 陈国芬, 孙瑞龙, 等. 23例室壁瘤临床病理的探讨. 中华心血管病杂志1982; 10: 278.

［5］陈在嘉, 徐义枢, 孔华宇, 主编. 临床冠心病学. 北京: 人民军医出版社, 1994: 121.

［6］Quyyumi A , Crake T , Wright C, et al. The role of ambulatory ST-segment monitoing in the odiagnosis of coronary artery disease: Comparison with exercise testing and thallium scintigraphy. EEur Heart J 1987; 8: 124.

［7］Tzivoni D, Gravish A , Benhorin J , et al. Myocardial ischemia during daily activities and stress. Am J Cardiol 1986; 58: 47B.

备注/Memo

备注/Memo:
Received 1996-03-22；revised 1996-09-23
更新日期/Last Update: 1996-08-01