基于心电网络系统的动态心电图危急值临床分析及应用  

Clinical analysis and application of critical values in ambulatory electrocardiography based on electrocardiogram network system

作　　者：冯艳[1] 麦五久代·吐尔逊 阿尔祖古丽·麦麦提 FENG Yan;TUERXUN Maiwujiudai;MAIMAITI Aerzuguli(Department of Electrocardiogram,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi Xinjiang 830001;Postgraduate College,Xinjiang Medical University,Urumqi Xinjiang 830011,China)

机构地区：[1]新疆维吾尔自治区人民医院心电学科,新疆乌鲁木齐830001 [2]新疆医科大学研究生院,新疆乌鲁木齐830011

出　　处：《实用心电学杂志》2024年第6期595-600,共6页Journal of Practical Electrocardiology

基　　金：新疆维吾尔自治区科技支疆项目(2021E02051)。

摘　　要：目的探讨动态心电图危急值报告的临床应用价值。方法纳入接受动态心电图检查的患者69053例,共检出有危急值报告的患者376例。回顾性分析检出的动态心电图危急值,总结其在临床中的应用价值。结果376例动态心电图危急值报告患者中有门诊患者65例,住院患者311例;动态心电图危急值报告通常出现在60岁以上的老年人群中。在5大类动态心电图危急值中,以急性冠脉综合征及严重的缓慢性心律失常发生率最高;在13小类动态心电图危急值中,以疑似心肌缺血或损伤、3~5 s的长PP间期发生率最高。男性患者急性冠脉综合征、严重的快速性心律失常发生率高于女性患者,女性患者严重的缓慢性心律失常、QT间期显著延长的发生率高于男性患者,且差异均有统计学意义(均P<0.05)。13小类动态心电图危急值报告主要来源科室是门诊和神经内科(住院)。结论动态心电图危急值多见于60岁以上人群,且男性与女性患者的危急值情况存在差异,建议针对不同性别的患者采取不同的管理策略,还需密切关注门诊和神经内科两个科室患者的心电图变化。Objective To explore the clinical application value of critical value reporting of ambulatory electrocardiography(AECG).Methods We enrolled 69 053 patients who had undergone AECG examination in the study,among whom a total of 376 patients with critical value reports were detected.A retrospective analysis was conducted on the detected AECG critical value reports to summarize their clinical application value.Results Out of 376 AECG critical value reports,there were 65 outpatients and 311 hospitalized patients.AECG critical value reports usually occurred in the elderly population aged 60 and above.The incidences of acute coronary syndrome and severe bradycardia were the highest in the five major categories of AECG critical values;among 13 subtypes of AECG critical values,the incidences of suspected myocardial ischemia or injury,and long PP interval of 3-5 seconds were the highest.The incidences of acute coronary syndrome and severe tachyarrhythmia were higher in male patients than those in female patients,while the incidences of severe bradycardia and significantly prolonged QT interval were higher in female patients than those in male patients,all with statistically significant differences(all P<0.05).The reports of the 13 subtypes of AECG critical values mainly originated from the outpatient and neurology departments(inpatient).Conclusion The critical values of AECG are more common in the population over 60 years old,and there are differences in critical value situations between male and female patients.Different management strategies are suggested to be adopted for patients of different sexes.And it is necessary to closely monitor the changes of electrocardiogram among patients in the outpatient and neurology departments.

关 键 词：心电网络系统 动态心电图危急值 急性冠脉综合征 缓慢性心律失常 心肌缺血或损伤 

分 类 号：R540.41[医药卫生—心血管疾病]