冠心病无痛性心肌缺血临床诊断及治疗效果.docVIP

冠心病无痛性心肌缺血临床诊断及治疗效果 　　doi：10.3969/j.issn.1007-614x.2014.11.8 　　摘 要 目的：探讨冠心病无痛性心肌缺血临床诊治。方法：收治冠心病无痛性心肌缺血患者100例，采用数字表抽取法随机分组，就复方丹参滴丸治疗（对照组，n=50）与加用硝苯地平联合硝酸异山梨酯治疗（观察组，n=50）效果进行比较。结果：100例患者中，心肌缺血性发作共监测到295次，ST段呈0.1～0.4mV改变。缺血发作时无典型症状63例，心悸和心绞痛37例。当心肌缺血发作，ST-T变化时，心律失常89例。两组治疗前ST段压低次数和平均持续时间比较差异无统计学意义（P0.05），治疗后均有减少，但观察组幅度明显优于对照组，差异有统计学意义（P0.05）。结论：临床冠心病无痛性心肌缺血较常见，定期行动态心电监测，并及时在早期确诊，制定针对性方案治疗，可改善预后，提高患者生存质量，具有非常重要的实施价值。 　　关键词 冠心病 无痛性心肌缺血 临床诊断 治疗 　　Clinical diagnosis and treatment effect of silent myocardial ischemia in patients with coronary heart diseas 　　Wu Hong 　　Department of Cardiovascular Medicine，the Traditional Chinese Medicine Hospital of Lanzhou City，Gansu 730050 　　Abstract Objective：To explore the clinical diagnosis and treatment of silent myocardial ischemia in patients with coronary heart disease.Methods：100 patients with coronary heart disease of silent myocardial ischemia were selected，they were randomly divided into the observation group and the control group with 50 cases in each.The control group was treated by compound Dan Shen dripping pills.The observation group added nifedipine and isosorbide dinitrate.The treatment effect of the two groups were compared.Results：In 100 patients，the number of myocardial ischemic attack was 95，ST had the 0.1～0.4mV change.At ischemic attack，63 patients did not have typical symptoms，37 patients had the symptoms of palpitation and angina pectoris.At myocardial ischemia attack and ST-T changes，89 patients were arrhythmia.Before treatment，the differences of ST segment depression times and average duration between the two groups were not significant（P0.05）；after treatment，two groups were decreased，but the observation group was significantly better than the control group，the difference was statistically significant（P0.05）.Conclusion：In clinical，coronary heart disease of silent myocardial ischemia is common，it easily lead to a bad consequences.The regular dynamic ECG monitoring，early diagnosis and developing targeted tr