中华老年多器官疾病杂志
中華老年多器官疾病雜誌
중화노년다기관질병잡지
Chinese Journal of Multiple Organ Diseases in the Elderly
2015年
10期
757-762
,共6页
远程心电监测%心电图%动态心电图%心律失常%诊断
遠程心電鑑測%心電圖%動態心電圖%心律失常%診斷
원정심전감측%심전도%동태심전도%심률실상%진단
remote electrocardiogram monitoring%electrocardiography%Holter%arrhythmia%diagnosis
目的：通过与常规12导联心电图（ECG）、24h动态心电图（Holter）比较，探讨远程心电监测（REM）应用于心律失常诊断的可行性和效果。方法选择2012年7月至2013年12月在江苏省苏北人民医院就诊的142例反复发作性胸闷、心慌、头晕、晕厥患者，3个月内每例酌情行REM一周至1个月，监测期间每天定时以及有症状时进行REM，随访期3个月内每例患者至少行3次ECG检查。其中72例同期进行了Holter检查，比较REM与ECG以及Holter对心律失常检出率的差异。结果142例行REM的患者中有10例脱落，REM共产生出6945份有效心电图，132例有效病例中REM与ECG分别检出105例（79.5%）及76例（57.6%）患心律失常，两者检出率差异有统计学意义（P＜0.05）。同时分别检出30例（22.7%）及26例（19.7%）患者心电图存在ST-T改变（P＞0.05），其中Holter检查的72例患者中， REM与Holter分别检出62例（86.1%）及52例（72.2%）心律失常患者（P＜0.05）；同时分别检出21例（29.2%）及25例（34.7%）患者心电图存在ST-T改变（P＞0.05）。结论 REM能及时准确诊断各种心律失常，诊断正确率几近100%，对院外的心律失常检出率显著高于ECG和Holter。
目的：通過與常規12導聯心電圖（ECG）、24h動態心電圖（Holter）比較，探討遠程心電鑑測（REM）應用于心律失常診斷的可行性和效果。方法選擇2012年7月至2013年12月在江囌省囌北人民醫院就診的142例反複髮作性胸悶、心慌、頭暈、暈厥患者，3箇月內每例酌情行REM一週至1箇月，鑑測期間每天定時以及有癥狀時進行REM，隨訪期3箇月內每例患者至少行3次ECG檢查。其中72例同期進行瞭Holter檢查，比較REM與ECG以及Holter對心律失常檢齣率的差異。結果142例行REM的患者中有10例脫落，REM共產生齣6945份有效心電圖，132例有效病例中REM與ECG分彆檢齣105例（79.5%）及76例（57.6%）患心律失常，兩者檢齣率差異有統計學意義（P＜0.05）。同時分彆檢齣30例（22.7%）及26例（19.7%）患者心電圖存在ST-T改變（P＞0.05），其中Holter檢查的72例患者中， REM與Holter分彆檢齣62例（86.1%）及52例（72.2%）心律失常患者（P＜0.05）；同時分彆檢齣21例（29.2%）及25例（34.7%）患者心電圖存在ST-T改變（P＞0.05）。結論 REM能及時準確診斷各種心律失常，診斷正確率幾近100%，對院外的心律失常檢齣率顯著高于ECG和Holter。
목적：통과여상규12도련심전도（ECG）、24h동태심전도（Holter）비교，탐토원정심전감측（REM）응용우심률실상진단적가행성화효과。방법선택2012년7월지2013년12월재강소성소북인민의원취진적142례반복발작성흉민、심황、두훈、훈궐환자，3개월내매례작정행REM일주지1개월，감측기간매천정시이급유증상시진행REM，수방기3개월내매례환자지소행3차ECG검사。기중72례동기진행료Holter검사，비교REM여ECG이급Holter대심률실상검출솔적차이。결과142례행REM적환자중유10례탈락，REM공산생출6945빈유효심전도，132례유효병례중REM여ECG분별검출105례（79.5%）급76례（57.6%）환심률실상，량자검출솔차이유통계학의의（P＜0.05）。동시분별검출30례（22.7%）급26례（19.7%）환자심전도존재ST-T개변（P＞0.05），기중Holter검사적72례환자중， REM여Holter분별검출62례（86.1%）급52례（72.2%）심률실상환자（P＜0.05）；동시분별검출21례（29.2%）급25례（34.7%）환자심전도존재ST-T개변（P＞0.05）。결론 REM능급시준학진단각충심률실상，진단정학솔궤근100%，대원외적심률실상검출솔현저고우ECG화Holter。
Objective To investigate the feasibility and effectiveness of remote electrocardiogram monitoring (REM) in the diagnosis of arrhythmia by comparison with 12-lead electrocardiography (ECG) and ambulatory electrocardiograph (Holter). Methods A total of 142 patients with complains of chest distress, palpitation, dizziness and syncope admitted to Northern Jiangsu People’s Hospital from July 2012 to December 2013 were recruited in this study. During the follow-up period within 3 months, all patients underwent REM for a period from 1 week to 1 month, at the same time every day or when symptoms presented, and also received totally at least 3 times of ECG. Meanwhile, 72 of them received Holter examination. The 3 diagnostic modes were compared for the positive rates of arrhythmia. Results Ten cases out of the 142 patients were excluded from the study. There were 6945 effective REM obtained from the rest 132 patients. Among them, 105 arrhythmia cases were detected by REM while 76 arrhythmia cases were detected by ECG (79.5% vs 57.6%, P<0.05). However, there were 30 ST-T change cases by REM, and 26 ST-T change cases by ECG (22.7% vs 19.7%, P>0.05). In 72 cases who had underwent Holter, REM had detected 62 arrhythmia cases and 21 ST-T change cases, while Holter detected 52 arrhythmia cases and 25 ST-T change cases. Significant difference was seen in the detection of arrhythmia (86.1% vs 72.2%, P<0.05) but not in ST-T changes (29.2% vs 34.7% P>0.05) between the 2 methods. Conclusion REM can accurately and timely detect arrhythmia, with near 100% of correct diagnosis, and more effective than ECG and Holter in the arrhythmia happening out of hospital.
