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一、定义和诊断方法无痛性心肌缺血(Silent myocardial ische mia,SMI)是指存在暂时性心肌缺血的客观证据,如心电图典型的缺血性ST变化,核医学或超声检查所示的灌注缺损及/或室壁运动异常而无临床心绞痛症状。近来应用~(201)铊~(82)铷和体外正电子检测装置(Positron-detecting devices)发现SMI时局部的心肌缺血变化与心绞痛发作时心肌缺血之表现相一致。Frishman认为SMI命名不够严谨,他主张痛疼不典型的心肌缺血,如以腹痛、肩痛或背痛为表现的心肌梗塞亦属此之列。 SMI的诊断方法主要有:①运动试验是诊断冠心病和对于已知有冠心病的患者进行
I. DEFINITIONS AND DIAGNOSIS Silent myocardial ischemic (SMI) refers to objective evidence of temporary myocardial ischemia, such as typical ischemic ST changes on ECG, as shown by nuclear medicine or sonography Infusion defects and / or wall motion abnormalities without clinical symptoms of angina pectoris. Recent application of ~ (201) thallium ~ (82) rubidium and Positron-detecting devices found that local changes in myocardial ischemia consistent with myocardial ischemia during angina attacks were found in SMI. Frishman believes that the SMI name is not rigorous enough, he advocated painless atypical myocardial ischemia, such as abdominal pain, shoulder pain or back pain as the performance of myocardial infarction is the case. SMI diagnostic methods are: ① exercise test is the diagnosis of coronary heart disease and coronary heart disease known to patients with