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老年冠心病患者无症状心肌缺血的临床研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2002年第5期
页码:
390-392
栏目:
临床研究
出版日期:
2002-09-01

文章信息/Info

Title:
A clinical study on silent myocardial ischemia in aged patients with coronary heart disease
作者:
张勇翔; 黄 晨; 张阳阳
第四军医大学西京医院老年病科惠宾病房,陕西西安710032
Author(s):
ZHANG Yong-xiang; HUANG Chen; ZHANG Yang-yang
Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi' an, Shaanxi710032, China
关键词:
心电描记术; 动态; 冠状动脉疾病; 无症状性心肌缺血; 心率变异性
Keywords:
electrocardiography; dynamic;  coronary disease;  silent myocardial ischemia;  heart rate variability
分类号:
R541
DOI:
-
文献标识码:
A
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256例老年冠心病患者行24 h动态心电图检测,检出心肌缺血167例,按临床情况分为3组:Ⅰ组:单纯SMI;Ⅱ组:有心绞痛史的患者;Ⅲ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。Ⅰ,Ⅱ,Ⅲ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, rMSSD, 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。冠心病患者心脏自主神经受损程度随着心肌缺血程度而加重。
Abstract:
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:Ⅰgroup: pure SMI;Ⅱgroup:patients with angina pectoris;Ⅲgroup: 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 SMIⅠ,ⅡandⅢgroups.The extension of ischemia had positive correlation with the incidence rate of ventricular arrhythmia, while negative correlation with SDNN, rMSSD, PMN50and 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.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2001-02-22.
更新日期/Last Update: 2002-09-01