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山东大学学报(医学版) ›› 2012, Vol. 50 ›› Issue (1): 94-.

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应用心脏远程监护技术分析静息性心肌缺血

张玉,伊永亮,余玫,魏敏,高海青   

  1. 山东大学齐鲁医院干部保健科, 济南 250012
  • 收稿日期:2011-02-12 出版日期:2012-01-10 发布日期:2012-01-10
  • 通讯作者: 高海青(1952- ), 男, 教授,博士生导师,主要从事老年心血管病的基础及临床研究。 Email:gaohaiqing52@yahoo.com.cn
  • 作者简介:张玉(1985- ), 女,医师,主要从事冠心病的一二级预防研究。

Analyzing resting myocardial ischemia with heart remote monitoring system

ZHANG Yu, YI Yong-liang, YU Mei, WEI Min, GAO Hai-qing   

  1. Department of Cadre Healthcare, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Received:2011-02-12 Online:2012-01-10 Published:2012-01-10

摘要:

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的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的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。

关键词: 心脏远程监护;静息性心肌缺血;冠状动脉痉挛

Abstract:

Objective   To distinguish two mechanisms of resting myocardial ischemia-coronary artery spasm and the other causes, determine the incidence of each mechanism in different coronary atherosclerosis(AS)populations with heart remote monitoring system. Methods   Enrolled all the patients who underwent the coronary arteriography or Computed Tomography of coronary arteriography(CTA), as well as Holter or iHolter, in the heart remote monitoring center from January 2009 to December 2010. Reviewed all the patients' records and reports of the Holter and iHolter , and performed all analyses with the statistical software program SPSS version 16.0. Results   The incidence of resting myocardial ischemia was more than 21.3% in the patients diagnosed with coronary artery disease by the coronary arteriography or CTA, while the incidence was more than 58.3%(P<0.05) in the patients only showed mild stenosis in CTA or with negative coronary arteriography. Analyzing the etiologies of the resting myocardial ischemia, coronary artery spasm accounted for more than 73.3%, while the other causes only accounted for less than 26.7%(P<0.05). Conclusions   The coronary arteriography can be used to distinguish the two mechanisms of the resting myocardial ischemia. And the coronary artery spasm is the chief mechanism of resting myocardial ischemia. The resting myocardial ischemia can easily happen in the patients only showed mild stenosis in CTA or with negative coronary arteriography.It is very important to monitor resting myocardial ischemia with the heart remote monitoring system.

Key words: Heart remote monitoring techniques; Resting myocardial ischemia; Coronary artery spasm

中图分类号: 

  • R540.4
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