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目的:探讨心电图对陈旧性心肌梗死的诊断效果观察。方法:对253例冠心病患者使用动态心电图监测,观察记录患者心肌缺血发作时间、发作症状、心率变化及ST段缺血性下移阵次。结果:126患者中发生心肌缺血103例,检出率81.7%,ST段下移发生1210阵次。无症状性心肌缺血患者68例,检出率66.1%,检出986阵次(81.49%),ST段下移幅度平均(0.23±0.06)mv;有症状心肌缺血35例,检出率33.9%,检出224阵次(18.51%),ST段下移幅度(0.17±0.08)mv;两组患者心肌缺血发生时,ST段下移幅度、阵次对比差异具有统计学意义(P<0.05);心肌缺血发生时间段主要集中在06:00~18:00,其中06:00~12:00时间段为发生心肌缺血高峰期。患者的缺血时间为23min/次。68例无症状性心肌缺血患者在监测过程中ST段下移时出现明显的心率加快,心肌缺血发作前患者心率平均为(70.53±6.8)次/min,发作时心率平均为(90.2±10.6)次/min,无症状性心肌缺血发生前后患者的心率变化差异具有统计意义(P<0.05)。结论:动态心电图可以有效诊断无症状性心肌缺血,并能够详细显示发作时间、缺血时间、是有效诊断无症状性心肌缺血的重要手段。
Objective: To investigate the effect of electrocardiogram on the diagnosis of old myocardial infarction. Methods: 253 cases of coronary heart disease patients using dynamic electrocardiogram monitoring, observation and recording of myocardial ischemic attack time, the onset of symptoms, heart rate changes and ST-segment ischemic down array. Results: There were 103 cases of myocardial ischemia occurred in 126 patients, the detection rate was 81.7% and the incidence of ST segment depression was 1210. In 68 patients with asymptomatic myocardial ischemia, the detection rate was 66.1%, 986 (81.49%) were detected, and the average ST-segment downward mobility was (0.23 ± 0.06) mv. Symptomatic myocardial ischemia was detected in 35 patients 33.9%, 224 (18.51%) were detected and the ST segment was down-shifted by (0.17 ± 0.08) mv. There was significant difference between the two groups in myocardial infarction <0.05). The duration of myocardial ischemia mainly concentrated in the period of 06: 00-18: 00, and the period of 06: 00-12: 00 was the peak period of myocardial ischemia. The patient’s ischemic time was 23 min / time. 68 patients with asymptomatic myocardial ischemia in the monitoring process ST segment down significantly faster heart rate, heart rate before myocardial ischemia in patients with an average of (70.53 ± 6.8) beats / min, the average heart rate at attack was (90.2 ± 10.6) times / min, there were significant differences in heart rate before and after asymptomatic myocardial ischemia (P <0.05). Conclusion: Holter can effectively diagnose asymptomatic myocardial ischemia, and can show the onset time and ischemic time in detail. It is an important means to diagnose asymptomatic myocardial ischemia effectively.