Osterspey A, Eggeling T, Götz C, Treis I, Höpp H W, Hombach V, Hilger H H
Medizinische Klinik III, Universität Köln.
Z Kardiol. 1988 Feb;77(2):103-9.
To evaluate spontaneous variability of ST-segment changes within the Holter ECG, in 20 patients with documented coronary heart disease (CHD) long-term ambulatory ECG recordings were performed over 3 consecutive days, when the patients were only receiving short-acting nitrates. ST-segment alterations per day were measured as the area beneath the baseline (mV x min), and were compared day-to-day intraindividually. The intra-day variations of ST-segment area alterations were a factor of about 10, when compared with the baseline values. Following administrations of 120 mg ISDN ret. at the beginning of day 4, the number of anginal attacks was reduced, as was the acute medication with short-acting nitrates. There was also a trend to reduction of ischemic ST-segment changes, but these reductions could not be confirmed statistically. In studies on the course and therapeutic interventions of patients with CHD, the phenomenon of spontaneous variability of ST-segment alterations must be taken into account--as applies also to the arrhythmia analysis within the Holter ECG--and the recording period must probably be prolonged beyond the 24-h limit presently used.
为评估动态心电图（Holter ECG）中ST段改变的自发变异性，对20例确诊为冠心病（CHD）的患者在仅接受短效硝酸盐治疗时连续3天进行了长期动态心电图记录。每天的ST段改变以基线以下面积（mV×min）来衡量，并在个体内进行逐日比较。与基线值相比，ST段面积改变的日内变化约为10倍。在第4天开始给予120mg缓释异山梨醇酯（ISDN ret.）后，心绞痛发作次数减少，短效硝酸盐的急救用药也减少。缺血性ST段改变也有减少趋势，但这些减少在统计学上未得到证实。在冠心病患者病程及治疗干预的研究中，必须考虑ST段改变的自发变异性现象（这同样适用于动态心电图中的心律失常分析），且记录期可能必须延长至目前使用的24小时时限以上。
