12导联实时可穿戴心电设备在家庭和基层医院患者远程早期事件监测中的应用  

Application of 12-lead real-time wearable ECG device for remote early event detection among patients at home and in primary hospitals

作　　者：王晋丽 陈韵岱 郜玲 文冬凌 郭亚涛 石亚君 WANG Jinli;CHEN Yundai;GAO Ling;WEN Dongling;GUO Yatao;SHI Yajun(Department of Cardiology,the First Medical Center,PLA General Hospital,Beijing 100853,China)

机构地区：[1]中国人民解放军总医院第一医学中心心血管内科,北京100853

出　　处：《实用心电学杂志》2021年第5期305-309,317,共6页Journal of Practical Electrocardiology

基　　金：北京市科委医药协同科技创新研究项目(Z181100001918011)。

摘　　要：目的分析12导联实时可穿戴心电设备监测家庭和基层医院患者远程早期事件的价值。方法在家庭和基层医院使用12导联实时可穿戴心电设备采集20271例受检者的心电图并传输至我院基层诊断会诊中心。按照危急、急和普通的等级对全部心电图数据进行分类,并及时告知患者及其家属或基层医院。对危急心电图病例在1~12 d内完成随访。结果共纳入21253份心电图进行分析。其中,男性12007份(56.50%),比例略高于女性;有11695份(55.03%)来源于基层医院,比例略高于来源于家庭的心电图。有40.55%(8619份)的心电图来自有不适症状的受检者,以胸闷胸痛和心慌心悸为主;66.63%的心电图(14160份)出现异常,其中心肌缺血心电图占39.45%(8385份),心律失常心电图占24.64%(5237份)。心律失常中室性早搏最多(5.52%)。危急心电图报告占0.61%(130份),来自94例受检者,其中20.21%(19/94)发生严重的临床事件。结论12导联实时可穿戴心电设备可以对家庭和基层医院患者的远程早期心律失常和心肌缺血进行监测,对远程心电进一步就诊进行危急、急和普通分类,可改善患者预后,最终惠及患者和基层医疗机构。Objective To analyze the value of 12-lead real-time wearable ECG device for remote early event detection among patients at home and in primary hospitals.Methods ECGs of 20271 subjects were collected by using 12-lead real-time wearable ECG devices at home and in primary hospitals,and transferred to the consultation center of our hospital.All of the ECG data were classified according to the degree of severity—critical,urgent and ordinary;the ECG grading results were timely notified patients themselves and their family members or primary hospitals.Critical ECG cases were followed up within 1 to 12 days.Results A total of 21253 ECGs are enrolled into analysis.Among them,male s ECGs account for 56.50%(12007/21253),slightly higher than female s;55.03%(11695/21253)of ECGs are collected from primary hospitals,slightly higher than those collected from families;40.55%(8619/21253)of ECGs come from subjects with symptoms of discomfort,mainly chest tightness,chest pain and palpitation.Abnormalities are found in 66.63%(14160/21253)of the ECGs including 39.45%(8385/21253)of myocardial ischemia ECGs and 24.64%(5237/21253)of arrhythmia ECGs with premature ventricular contraction ECGs accounting for the highest detection rate of 5.52%.Critical ECG reports account for 0.61%(130/21253),and serious clinical events occur in 20.21%(19 cases)of the involved 94 subjects.Conclusion The 12-lead real-time wearable ECG device can make remote early detection for arrhythmia and myocardial ischemia among patients at home and in primary hospitals,and divide remote ECGs into critical,urgent,and ordinary grades for further diagnosis.It can improve patients prognosis,and ultimately benefit patients and primary medical institutions.

关 键 词：可穿戴设备 心电图 移动医疗 远程医疗 远程心电监护 心律失常 心肌缺血 

分 类 号：R319[医药卫生—基础医学]