CAJ | 학술논문

目的旨在评价远程实时心电监测系统应用于急性ST段抬高心肌梗死(STEMI)心电信号的有效性,评价心肌缺血的准确性,并探讨其在STEMI中的临床使用价值.方法入选2008年4月至2010年12月北京阜外心血管病医院收治的60例STEMI患者.所有受试者均进行远程心电监测及常规12导联心电图机监测,并分成远程心电图组和常规心电图组进行比较.远程心电图组采集模拟V1、V3和V5导联及Ⅰ导联.分别测量两组心电图P波时限、PR间期、QRS波时限、T波时限、QT间期等指标,以及各导联P波振幅、QRS波振幅、QRS综合压代数和压差即R-(Q+S),T波振幅等指标,比较两组心电图对心律失常的检出率,两组在V1、V3和V5导联及Ⅰ导联中心电波形的一致性和各导联ST段改变的敏感性.数据分析采用成组t检验、秩和检验、Pearson相关分析法、Spearman秩相关和x2检验.结果经检验STEMI患者,两组图形在心率、P波时限、PR间期、QRS波时限、T波时限、QT间期等参数均差异无统计学意义(P＞0.05),参数相关良好(P＜0.01).两组合并心律失常检出率差异无统计学意义(P＞0.05).除V1导联远程心电图ST段抬高诊断符合率低于常规12导联心电图外(P＜0.05),V3、V5和Ⅰ导联ST段抬高诊断符合率与12导联心电图相符(P＞0.05).结论远程心电监测有助于STEMI患者心肌缺血部位的判定,且能够检测出心肌梗死后的心律失常,因此肯定了远程心电监测系统对STEMI的应用价值.
목적 지재평개원정실시심전감측계통응용우급성ST단태고심기경사(STEMI)심전신호적유효성,평개심기결혈적준학성,병탐토기재STEMI중적림상사용개치.방법 입선2008년4월지2010년12월북경부외심혈관병의원수치적60례STEMI환자.소유수시자균진행원정심전감측급상규12도련심전도궤감측,병분성원정심전도조화상규심전도조진행비교.원정심전도조채집모의V1、V3화V5도련급Ⅰ도련.분별측량량조심전도P파시한、PR간기、QRS파시한、T파시한、QT간기등지표,이급각도련P파진폭、QRS파진폭、QRS종합압대수화압차즉R-(Q+S),T파진폭등지표,비교량조심전도대심률실상적검출솔,량조재V1、V3화V5도련급Ⅰ도련중심전파형적일치성화각도련ST단개변적민감성.수거분석채용성조t검험、질화검험、Pearson상관분석법、Spearman질상관화x2검험.결과 경검험STEMI환자,량조도형재심솔、P파시한、PR간기、QRS파시한、T파시한、QT간기등삼수균차이무통계학의의(P＞0.05),삼수상관량호(P＜0.01).량조합병심률실상검출솔차이무통계학의의(P＞0.05).제V1도련원정심전도ST단태고진단부합솔저우상규12도련심전도외(P＜0.05),V3、V5화Ⅰ도련ST단태고진단부합솔여12도련심전도상부(P＞0.05).결론 원정심전감측유조우STEMI환자심기결혈부위적판정,차능구검측출심기경사후적심률실상,인차긍정료원정심전감측계통대STEMI적응용개치.
Objective To investigate the reliability of electrocardiographic (ECG) signal for the accurate assessment of myocardial ischemia in order to evaluate the clinical value of remote real-time ECG monitoring system based on GPRS in patients with acute ST-elevation myocardial infarction (STEMI).Methods A total of 60 STEMI patients admitted between April 2008 and December 2010 were enrolled.All subjects were given the remote real-time ECG monitoring and routine 12 leads ECG monitoring at the same time.They were divided into remote ECG group and the 12 leads ECG group.The remote real-time ECG monitoring collects electrocardiosignal to imitate V1,V3,V5 lead and Ⅰ lead.P wave duration,PR interval,duration of time limit of QRS wave and T wave,QT interval,and the P wave amplitude,QRS wave amplitude,R-(Q + S),T wave amplitude were measured,and the detectability rate of arrhythmia and the definited diagnosis rate of ST segment elevation in accordance with clinical manifestion were compared in each group with different parameters.The data were analyzed by t test,rank sum test,Pearson correlation analysis,Spearman's rank correlation and the chi-square test.Results In STEMI patients,there were no statistical differences in time limits and amplitude of waves on ECG between the two groups (P ＞ 0.05),and the correlations between parameters of two groups were found to be close (P ＜ 0.01).There was no difference in the detectability rate of cardiac arrhythmia between two groups (P ＞ 0.05),and no difference in the rate of correct diagnosis of elevated ST segment between two groups (P ＞ 0.05),except V1 lead (P ＜ 0.05).Conclusions The sensitivity of the change in ST segment of the two groups is similar,and the remote real-time ECG monitoring can help determine the location of myocardial ischemia.