穿戴式长程动态心电监测仪在社区居家老年人群中的监测研究  

Monitoring of wearable long-range ambulatory electrocardiographic monitor for a community-based homebound elderly population

作　　者：袁志权 邬娜[1] 焦惠艳 李成英 吴龙[1] 聂朦 许月瑶 杨蕾 王煜 伍永红 钟理 李亚斐[1] YUAN Zhiquan;WU Na;JIAO Huiyan;LI Chengying;WU Long;NIE Meng;XU Yueyao;YANG Lei;WANG Yu;WU Yonghong;ZHONG Li;LI Yafei(Department of Epidemiology,Faculty of Military Preventive Medicine,Army Medical University(Third Military Medical University),Chongqing,400038;Health Service Center of Shuangbei Community of Shapingba District,Chongqing,400032;School of Public Health,Key Laboratory of Environmental Pollution Monitoring and Disease Control of Ministry of Education,Guizhou Medical University,Guiyang,Guizhou Province,561113;Jiulongpo District Center for Disease Control and Prevention,Chongqing,400039;Cardiovascular Disease Center,the Third Affiliated Hospital of Chongqing Medical University,Chongqing,401120,China)

机构地区：[1]陆军军医大学(第三军医大学)军事预防医学系军队流行病学教研室,重庆400038 [2]沙坪坝区双碑社区卫生服务中心,重庆400032 [3]贵州医科大学公共卫生与健康学院环境污染与疾病监控教育部重点实验,贵阳561113 [4]九龙坡区疾病预防控制中心,重庆400039 [5]重庆医科大学附属第三医院心血管疾病中心,重庆401120

出　　处：《陆军军医大学学报》2024年第11期1316-1322,共7页Journal of Army Medical University

摘　　要：目的对社区居家老年人群进行动态心电监测结果调查,并探讨穿戴式长程动态心电监测仪在社区居家老年人群中的适用性。方法于2021年11月至2023年6月在重庆市沙坪坝区双碑社区招募老年志愿者,采用单导联穿戴式动态心电记录仪进行连续7 d的心电监测,描述设备穿戴中的不良反应、可接受度、监测时长、心电监测结果。严重心律失常事件包含频发房早、心房扑动、心房颤动(房颤)、频发室早、RR间期≥5 s心律失常事件。结果共416例研究对象纳入分析,年龄(71.2±6.6)岁,男性150人(36.1%);384例(92.3%)研究对象完成7 d佩戴,佩戴时长(159.2±29.4)h。179例(48.5%)研究对象穿戴心电监测设备无任何不适,175例(47.4%)佩戴部位皮肤瘙痒。监测结果显示,常见的心律失常依次为房性早搏(97.1%)、室性早搏(93.3%)、房性心动过速(84.6%)、心动过缓(46.6%)、频发房性早搏(15.1%)、室性心动过速(13.2%)、长RR间期(11.8%)等。其中29.1%的研究对象有严重心律失常事件,高龄(≥70岁)、有既往心脏疾病史的人群某些严重心律失常事件检出率较高。结论社区居家老年人群常见心律失常检出率较高,监测周期7 d可能较合适。Objective To investigate the results of ambulatory electrocardiographic(ECG)monitoring in a community-based homebound elderly population and to explore the applicability of wearable long-range ambulatory ECG monitor for them.Methods Elderly volunteers were recruited in Shuangbei Community,Shapingba District,Chongqing,from November 2021 to June 2023.A single-lead wearable ambulatory ECG recorder was applied to them to obtain ECG for 7 consecutive days.The adverse reactions,acceptability,monitoring duration,and arrhythmia detection rate during the wearing were described and recorded.Serious arrhythmic events included frequent atrial premature,atrial flutter,atrial fibrillation(AF),frequent ventricular premature,and RR intervals≥5 s.Results There were 416 individuals enrolled,with a mean age of 71.2±6.6 years,and a male percentage of 36.1%(150 men).Finally,384(92.3%)participants completed the wearing of the ECG monitor for 7 d,with an average time of 159.2±29.4 h.There were 179 participants(48.5%)reporting no discomfort during wearing,and 175 ones(47.4%)feeling itchy at the wearing site.The monitoring results showed that the common arrhythmias were atrial premature contractions(97.1%),premature ventricular contractions(93.3%),atrial tachycardia(84.6%),bradycardia(46.6%),frequent atrial premature contractions(15.1%),ventricular tachycardia(13.2%),and long RR interval(11.8%).Among them,29.1%of the participants experienced serious arrhythmic events,and the detection rate of certain serious arrhythmic events was comparatively higher in the individuals≥70 years of age and those with history of previous cardiac disease.Conclusion The detection rate of common arrhythmias is quite high in the community-based homebound elderly population.A 7-day long-range ambulatory ECG monitoring may be appropriate.

关 键 词：心律失常 长程动态心电监测 社区老年人群 

分 类 号：R181.37[医药卫生—流行病学] R540.41[医药卫生—公共卫生与预防医学] R541.7