远程实时传输12导联心电图对急性ST段抬高性心肌梗死患者的院前诊断价值  

Study of the pre-hospital diagnostic reliability of real-time tele-transmission of 12-lead electrocardiogram of patients with acute ST-segment elevated myocardial infarction

作　　者：罗望胜[1] 向定成[2] 张金霞[2] 秦伟毅[2] 彭雄[2] 易绍东[2] 

机构地区：[1]南方医科大学研究生院,广州510515 [2]广州军区广州总医院心血管内科

出　　处：《中华急诊医学杂志》2013年第6期669-673,共5页Chinese Journal of Emergency Medicine

基　　金：广州市科技计划专项（穗科信字2011179号）;广州市科技计划项目（2012J4300107）;广东省科技计划重点项目（2011A011304002）;广东省科技计划重大项目（2012A080104020）

摘　　要：目的评价远程实时传输12导联心电图对ST段抬高性急性心肌梗死（STEMI）的诊断价值。方法选择40例STEMI患者采用同时进行远程实时传输12导联心电图和常规12导联心电图记录，采用配对t检验和秩和检验比较相同导联各波形的时限、振幅及ST段偏移程度，用Pearson分析ST段抬高相关性。结果两种方法所测得STEMI患者的心电图各波形的时限、振幅及ST段偏移程度等参数问差异无统计学意义（P〉0．05），两种方法检测的ST抬高幅度高度相关（r=0．912，P=0．000），二者之间的符合率高（Kappa值为0．976），结论远程实时传输12导联心电图监测系统所记录和传输的心电信号准确、可靠，可用于STEMI的院前诊断。Objective To evaluate the pre-hospital diagnostic reliability of real-time teletransmission of 12-lead electrocardiogram of patients with ST-segment elevated acute myocardial infarction （STEMI）. Methods The 12-lead electrocardiogram was simultaneously recorded with real- time teletransmission system and a conventional electrocardiograph in 40 STEMI cases. The width and amplitude of each wave, the deviated amplitude of ST-segment in the same leads were compared by t-test and rank-sum test. Results There were no statistical differences in the width and amplitude of P wave, QRS wave and t wave as well as the deviated altitude of ST-segment between the two separate electrocardiographs （P 〉 0. 05）. There was a significant positive correlation between the two ECG devices in respect of ST-segment elevated altitude （ r = 0. 912, P= 0. 000 ）. The differential ability of ST-segment elevation between two separate ECG devices kept highly consistent （ Kappa value ： 0. 976 ）. Conclusions Real - time tele - transmission of 12-lead electrocardiogram is reliable for the pre-hospital diagnosis of STEMI.

关 键 词：急性心肌梗死 心电图 远程心电图 实时 远程医疗 远程心电监测 无线 3G 院前诊断 准确性 可靠性 

分 类 号：R542.22[医药卫生—心血管疾病]