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目的应用心脏远程监护技术分析静息性心肌缺血的冠状动脉痉挛和冠状动脉严重狭窄心肌耗氧量增加两种机制各占的比例,统计静息性心肌缺血在不同人群中的发病率。方法查阅患者病历记录,根据冠状动脉造影结果及冠状动脉成形术结果筛选入选患者,查阅入选患者心脏远程监护记录及动态心电图诊断报告,计算静息性心肌缺血两种机制各占的比例及静息性心肌缺血在不同人群中的发病率,并作统计学分析。结果冠心病患者静息性心肌缺血发生率≥21.3%,冠状动脉有一定程度狭窄,但未达到冠心病诊断标准患者静息性心肌缺血发生率≥58.3%(P<0.05)。冠状动脉痉挛在所有发生静息性心肌缺血的机制中所占比例≥73.3%,非冠状动脉痉挛的原因所占比例≤26.7%(P<0.05)。结论冠状动脉造影可以鉴别诊断导致静息性心肌缺血的冠状动脉痉挛和冠状动脉狭窄心肌耗氧量增加的两种机制;静息性心肌缺血发生机制中冠状动脉痉挛所占的比重大;冠状动脉有一定程度的狭窄但未达到冠心病诊断标准的患者比冠心病患者更易发生静息性心肌缺血;心脏远程监护技术的连续监测对于静息性心肌缺血的诊断具有重要意义。
Objective To analyze the proportion of coronary heart disease (CHF) and myocardial infarction (MI) in patients with severe coronary artery stenosis by heart remote monitoring technique. The incidence of resting myocardial ischemia in different populations was calculated. Methods The patient records were reviewed. The selected patients were screened based on the results of coronary angiography and coronary angioplasty. The telemonitoring records and the report of dynamic electrocardiogram (ECG) of the selected patients were screened. The proportions of static myocardial ischemia and static electrocardiogram Incidence of myocardial ischemia in different populations, and for statistical analysis. Results The incidence of resting myocardial ischemia in patients with coronary heart disease was ≥21.3%. The coronary artery was stenosed to a certain degree. However, the incidence of resting myocardial ischemia ≥58.3% (P <0.05) did not reach the diagnostic criteria of coronary heart disease. Coronary artery spasm accounted for 73.3% of all the mechanisms of resting myocardial ischemia and 26.7% of non-coronary artery spasms (P <0.05). Conclusions Coronary angiography can differentiate the two mechanisms of coronary artery spasm and myocardial oxygen consumption caused by resting myocardial ischemia and coronary heart disease; the proportion of coronary artery spasm in resting myocardial ischemia is larger; Patients with coronary artery stenosis but not meeting the diagnostic criteria for coronary heart disease are more likely to have resting myocardial ischemia than patients with coronary artery disease. Continuous monitoring of cardiac remote monitoring techniques is of great importance for the diagnosis of resting myocardial ischemia.