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[利用心电图标测对复极异常进行逐步评估]

[Gradual evaluation of repolarization disorders with ECG mapping].

作者信息

Kehl K

机构信息

Institut für Klinische Ultraschalldiagnostik, Klinikums Berlin-Buch.

出版信息

Z Gesamte Inn Med. 1990 Dec 1;45(23):709-14.

PMID:2102026
Abstract

143 test persons, (31 healthy persons, 30 borderline cases and 82 patients with chronic coronary heart disease) were examined at rest and on submaximal exertion by means of a mapping ECG (72 electrodes) and their findings were valuated depending upon the severity of the chronic coronary heart disease. The significance of the individual mapping ECG parameters in gradually valuating the disturbances of repolarisation was stated by correlation to the severity of the chronic heart disease and decreased in following order: 1. relative surfaces, 2. total surface with ST decrease in mV, 3. maximum decrease of ST, 4.4. sum of the decrease of ST in mV, 5. sum of negative area integrals of ST and 6. the minimum quotient of increase. The extension of a myocardial ischaemia could be stated with the total area by means of decreases of ST and its maximum by means of the maximal decrease of ST. The severity of the coronary heart disease could be gradually estimated with the "relative surfaces" of the mapping ECG at rest in mild to moderate degrees of severity and under submaximal exertion in all degrees of severity of the coronary heart disease. In a gradual evaluation of the mapping ECG the extension, the intensity, localisation and kind of the disturbance of the myocardium must be considered with regard to the dipole behaviour and to the potential decrease of the cardioelectric field as well as to the degree of severity of the disease.

摘要

143名受试人员(31名健康人、30名临界病例和82名慢性冠心病患者)在静息状态和次极量运动时通过标测心电图(72导联)进行检查,并根据慢性冠心病的严重程度对检查结果进行评估。通过与慢性心脏病的严重程度相关联,阐述了各个标测心电图参数在逐步评估复极紊乱中的意义,其重要性依次递减:1. 相对面积;2. ST段压低以mV为单位的总面积;3. ST段最大压低;4. ST段压低以mV为单位的总和;5. ST段负向面积积分总和;6. 最大上升商。可通过ST段压低的总面积确定心肌缺血范围,通过ST段最大压低确定其最大值。在轻度至中度严重程度下,可根据静息时标测心电图的“相对面积”逐步评估冠心病的严重程度;在冠心病所有严重程度下,可根据次极量运动时的情况进行评估。在对标测心电图进行逐步评估时,必须考虑心肌紊乱的范围、强度、定位和类型,以及偶极行为、心电场电位降低情况和疾病严重程度。

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