便携式单导联心电仪在社区老年心房颤动筛查中的应用  

Application of portable single lead electrocardiograph in atrial fibrillation screening in the community elderly people

作　　者：潘桂俊 李艳 石玉霜 陆萍 宋玮 王惠华 PAN Guijun;LI Yan;SHI Yushuang;LU Ping;SONG Wei;WANG Huihua(General Practice Department of Jinyang Community Health Service Center of Pudong New District,Shanghai 200136,China)

机构地区：[1]上海市浦东新区金杨社区卫生服务中心全科,上海200136

出　　处：《上海医药》2024年第2期39-43,共5页Shanghai Medical & Pharmaceutical Journal

基　　金：上海市浦东新区卫健委社区科研基金项目(PW2022A-16)。

摘　　要：目的:评价单导联心电仪用于社区老年人群中心房颤动(房颤)筛查的可行性,分析社区老年房颤筛查的人群特征。方法:选取上海市浦东新区金杨社区1300例65岁以上老年人为研究对象,其中男性559人,平均年龄(71.73±5.08)岁;女性741人,平均年龄(71.12±4.81)岁。使用“心安宝”便携式单导联心电记录仪结合脉搏触诊和12导联心电图进行机会性筛查,比较脉搏触诊和单导联心电记录仪的敏感性和特异性,分析非房颤对象与房颤患者的基本特征。结果:单导联心电记录仪筛查房颤的敏感性为90.3%,特异性为87.8%。在1300人参与筛查老年人中检出房颤93例(7.1%),其中新发房颤30例,新发房颤检出率为2.4%。老年男性和女性的房颤检出率差异无统计学意义(P>0.05)。75岁以上的老年人发生房颤的机率明显增加(P<0.01)。房颤患者和非房颤对象对房颤相关知识认知的差异无统计学意义(P>0.05)。房颤患者CHA2DS2-VASC评分高于非房颤对象,差异有统计学意义(P<0.01)。logistic多因素分析显示,>75岁(OR=5.0,95%Cl:1.74~45.51,P=0.019)、高血压(OR=8.717,95%Cl:4.301~17.667,P<0.001)、冠心病(OR=2.251,95%Cl:1.041~4.870,P=0.039)、CHA2DS2-VASC评分(OR=2.910,95%Cl:1.775~4.772,P<0.001)是老年人发生房颤的危险因素。结论:便携式单导联心电记录仪筛查房颤具有便捷,高效,敏感性和特异性高等特点,用于社区老年人群的房颤筛查是可行的。75岁以上人群的房颤检出率较,高血压,冠心病,CHA2DS2-VASC评分高是引起房颤的危险因素,在这些人群中进行房颤筛查可能会有更大的成本效益。Objective:To evaluate the feasibility of application of single lead electrocardiograph in atrial fibrillation screening in the community elderly people,and analyze the population characteristics of atrial fibrillation screening in the community elderly people.Methods:In Jinyang Community of Pudong New District,Shanghai 1300 elderly people over 65 years old were selected as the research objects,among them,there were 559 males and the average age was(71.73±5.08)years;there were 741 females and the average age was(71.12±4.81)years.“Xinanbao”portable single lead electrocardiogram recorder combined with pulse palpation and 12 lead electrocardiogram was used for opportunity screening to compare the sensitivity and specificity of pulse palpation and single lead electrocardiogram to analyze the basic characteristics of patients with non-atrial fibrillation and atrial fibrillation.Results:Single lead electrocardiogram sensitivity for atrial fibrillation screening was 90.3%and specificity 87.8%;in 1300 participants participated in screening,93 cases(7.1%)of atrial fibrillation were detected,including 30 new atrial fibrillation,and the new detection rate was 2.4%.The incidence of atrial fibrillation was not statistically significant in the elderly men and women(P>0.05);the probability of atrial fibrillation in the elderly people over 75 years old increased significantly(P<0.01);there was no significant difference in cognition of atrial fibrillation related knowledge between the atrial fibrillation and non-atrial fibrillation objects(P>0.05).The CHA2DS2-VASC score in the atrial fibrillation patients was higher than that in the non-atrial fibrillation patients(P<0.01).The logistic multivariate analysis showed that>75 years old(OR=5.0,95%Cl:1.74~45.51,P=0.019),hypertension(OR=8.717,95%Cl 4.301~17.667,P=0.001),coronary heart disease(OR=2.251,95%Cl 1.041~4.870,P=0.039),CHA2DS2-VASC score(OR=2.910,95%Cl 1.775~4.772,P=0.001)were the risk factors for developing atrial fibrillation in the elderly.Conclusion:Portable single lea

关 键 词：心房颤动 便携式单导联心电记录仪 老年人 社区 应用 

分 类 号：R541.7[医药卫生—心血管疾病]