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目的探讨老年男性冠心病患者无症状心肌缺血的发作特点及动态心电图诊断的价值。方法选择行动态心电图检查的老年男性冠心病患者350例,按年龄分为Ⅰ组(年龄60～79岁,220例)和Ⅱ组(80～91岁,130例),对两组患者动态心电图结果进行对比分析,并与常规心电图结果进行比较。结果Ⅱ组患者的常规心电图及动态心电图的心肌缺血检出率及无症状心肌缺血平均持续时间均高于Ⅰ组,但差异无统计学意义(p>0.05);Ⅰ组无症状心肌缺血发作有明显昼夜节律,Ⅱ组无明显昼夜节律;两组慢频率依赖型无症状心肌缺血持续时间均较快频率依赖型无症状心肌缺血延长(p<0.05),且Ⅱ组较Ⅰ组明显;快频率依赖型无症状心肌缺血平均ST段压低幅度与慢频率依赖型无症状心肌缺血平均ST段压低幅度比较,以及Ⅰ,Ⅱ组无症状心肌缺血平均ST段压低幅度比较差异均无统计学意义(p>0.05)。结论随着年龄增加,老年男性冠心病患者无症状心肌缺血发生率增高,且无症状心肌缺血持续时间延长;>80岁男性冠心病患者无症状心肌缺血发作无明显昼夜节律,慢频率依赖型无症状心肌缺血持续时间较快频率依赖型无症状心肌缺血显著延长。动态心电图是检测和评估老年冠心病患者无症状心肌缺血的重要手段。
Objective To investigate the characteristics of asymptomatic myocardial ischemia in elderly patients with coronary heart disease and the value of dynamic electrocardiogram. Methods A total of 350 elderly patients with CHD who underwent active electrocardiogram (ECG) examination were divided into two groups according to their age: group Ⅰ (aged 60-79 years, 220 cases) and group Ⅱ (aged 80-91 years, 130 cases). The dynamic electrocardiogram The results were compared and analyzed with conventional ECG results. Results The detection rate of myocardial ischemia and the duration of asymptomatic myocardial ischemia in routine electrocardiogram and dynamic electrocardiogram in group Ⅱ were higher than those in group Ⅰ, but the difference was not statistically significant (p> 0.05). In group Ⅰ, asymptomatic myocardial ischemia There was a significant circadian rhythm in seizures and no significant circadian rhythm in group Ⅱ. The duration of slow-onset frequency-dependent asymptomatic myocardial ischemia was prolonged in both groups (p <0.05) Group was significantly; fast frequency-dependent asymptomatic myocardial ischemia average ST segment depression and slow frequency-dependent asymptomatic myocardial ischemia average ST segment depression amplitude, and Ⅰ, Ⅱ asymptomatic myocardial ischemic mean ST segment depression compared There was no significant difference (p> 0.05). Conclusions With the increase of age, the incidence of asymptomatic myocardial ischemia in elderly men with coronary heart disease increased, and the duration of asymptomatic myocardial ischemia prolonged; asymptomatic myocardial ischemia in men> 80 years old had no obvious circadian rhythm, slow frequency Dependent asymptomatic myocardial ischemia lasting faster frequency dependent asymptomatic myocardial ischemia was significantly prolonged. Holter monitoring and assessment of elderly patients with coronary heart disease as an important means of myocardial ischemia.