Pelter Michele M, Adams Mary G, Drew Barbara J
Department of Physiological Nursing, University of California, San Francisco, USA.
Am J Crit Care. 2002 Jul;11(4):318-25.
Little is known about the frequency or consequences of transient myocardial ischemia in patients admitted to a telemetry unit for treatment of angina.
To compare the rate of transient myocardial ischemia in a group of patients with angina treated in a telemetry unit with the rate in a similar group treated in a coronary care unit and to determine if transient myocardial ischemia is associated with adverse in-hospital outcomes.
Continuous 12-lead electrocardiography was used to monitor changes in the ST segment in 186 patients in the coronary care unit (1994-1996) and 186 patients in the telemetry unit (1997-2000). Transient myocardial ischemia was defined as a change from baseline of 100 microV or more in the ST segment in 1 or more leads lasting 60 seconds or longer
The rate of transient myocardial ischemia was 15% for patients in the telemetry unit and 19% for patients in the coronary care unit. Regardless of hospital unit, patients with transient myocardial ischemia were more likely than those without this complication to experience death or acute myocardial infarction after hospital admission. Most patients did not experience signs or symptoms during transient myocardial ischemia: 71% of patients in the telemetry unit versus 58% of patients in the coronary care unit (P =.28).
Transient myocardial ischemia is common among patients with angina treated in a telemetry unit. ST-segment monitoring may be useful for detecting patients with ischemia who may benefit from more aggressive therapies aimed at abolishing ongoing ischemia.
对于因心绞痛入院接受遥测监护治疗的患者，短暂性心肌缺血的发生率及后果了解甚少。
比较在遥测监护病房接受治疗的一组心绞痛患者与在冠心病监护病房接受治疗的类似患者组中短暂性心肌缺血的发生率，并确定短暂性心肌缺血是否与不良院内结局相关。
采用连续12导联心电图监测冠心病监护病房的186例患者（1994 - 1996年）和遥测监护病房的186例患者（1997 - 2000年）的ST段变化。短暂性心肌缺血定义为1个或多个导联的ST段相对于基线变化100微伏或更多，持续60秒或更长时间。
遥测监护病房患者的短暂性心肌缺血发生率为15%，冠心病监护病房患者为19%。无论在哪个病房，发生短暂性心肌缺血的患者入院后发生死亡或急性心肌梗死的可能性均高于无此并发症的患者。大多数患者在短暂性心肌缺血期间未出现体征或症状：遥测监护病房71%的患者，冠心病监护病房58%的患者（P = 0.28）。
在遥测监护病房接受治疗的心绞痛患者中，短暂性心肌缺血很常见。ST段监测可能有助于检测出那些可能从旨在消除持续性缺血的更积极治疗中获益的缺血患者。
