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目的:探讨冠心病患者冠状动脉狭窄程度与心肌缺血总负荷的关系,评估心肌缺血总负荷对冠状动脉狭窄程度的临床价值。方法:110例临床疑似冠心病患者行十二导动态心电图检查及冠状动脉造影,按冠状动脉造影结果分为4组:冠状动脉血管狭窄70%~99%组(A组)、50%~70%组(B组)、<50%组(C组)和正常组(D组)。A组至少有一支冠状动脉完全闭塞含多支病变,B组至少有一支冠状动脉有不同程度狭窄含双支病变,C组为单支冠状动脉有狭窄而不能确诊冠心病,D组为冠状动脉造影完全正常。通过十二导动态心电图检查计算24 h心肌缺血总负荷。结果:随冠状动脉狭窄程度增加、冠状动脉病变支数的增加,心肌缺血总负荷显著增加。结论:冠心病患者心肌缺血总负荷增高提示冠状动脉狭窄程度加重,冠心病患者病情加重。心肌缺血总负荷对评价冠心病病情预后及指导治疗有重要价值。
Objective: To investigate the relationship between the degree of coronary artery stenosis and the total myocardial ischemic load in patients with coronary heart disease and to evaluate the clinical value of total myocardial ischemic load on the degree of coronary artery stenosis. Methods: One hundred and twelve patients with clinically suspected coronary heart disease underwent 12-lead ECG and coronary angiography. The patients were divided into 4 groups according to coronary angiography: 70% -99% of coronary artery stenosis (group A), 50% -70 % Group (group B), <50% group (group C) and normal group (group D). Group A at least one coronary artery occlusion with multiple lesions, group B at least one coronary artery stenosis with varying degrees of double-vessel disease, C group of coronary stenosis coronary artery disease can not be diagnosed, D coronary artery Angiography is completely normal. The total 24-h myocardial ischemic load was calculated by twelve-lead dynamic electrocardiography. Results: With the increase of coronary artery stenosis, the number of coronary lesions increased, the total myocardial ischemia increased significantly. Conclusion: The increase of total myocardial ischemic load in patients with coronary heart disease suggests that the degree of coronary artery stenosis is aggravated, and the patients with coronary heart disease are exacerbated. The total load of myocardial ischemia has important value in evaluating the prognosis and guiding treatment of coronary heart disease.