北京生物醫(yī)學工程

攜帶式遠程實時心電監(jiān)測儀在心律失常診斷中的應(yīng)用

Application of portable remote real-time electrocardiogram monitor in cardiac arrhythmia diagnosis

作者：韓智紅任學軍王云龍汪燁聶建明宋月潔

單位：首都醫(yī)科大學附屬北京安貞醫(yī)院-北京市心肺血管疾病研究所(北京100029)

分類號：

出版年·卷·期（頁碼）：2013·32·6（613-617）

摘要：

目的通過與動態(tài)心電圖(Holter)記錄的心電圖比較，檢驗攜帶式遠程實時心電檢測儀(AKM-N1型，簡稱心電檢測儀)臨床應(yīng)用的價值。方法選取2011年10～11月在北京安貞醫(yī)院心內(nèi)科住院和門診以心律失常為主要表現(xiàn)的心臟病患者36例，其中男性21例，女性15例，平均年齡（43.0±14.8）歲。所有入選患者同時行心電檢測儀和Holter監(jiān)測，比對兩者同步記錄的心電圖數(shù)據(jù)(包括P波時限、PR間期、QRS波群時限、QT間期、RR間期、有無偽差與干擾、有無心律失常及心律失常類型)是否一致。兩組分別選取相同時間點比對上述參數(shù)，包括記錄的第10分鐘、第20分鐘、第30分鐘、第40分鐘和第50分鐘開始的30s心電數(shù)據(jù)，以及在受試者心臟不適或臨床醫(yī)生指示的情況下，2次同步按壓兩者的“捕捉鍵”進行心電捕捉的30s記錄。結(jié)果 36例入選患者有29例檢測到心律失常。兩種檢測方法得到的不同時間的P波時限、QRS波群時限、PR間期、QT間期與RR間期無差異，兩種方法檢出心律失常的情況高度關(guān)聯(lián)（P<0.001），檢出心律失常的比例無差異（P=1.0）。兩種檢測方法出現(xiàn)偽差與干擾的比例無差別，但出現(xiàn)偽差與干擾情況的關(guān)聯(lián)性不肯定。臨床試驗過程無不良反應(yīng)。結(jié)論攜帶式遠程實時心電監(jiān)測儀（AKM-N1型）獲得的心電數(shù)據(jù)準確，對心律失常的診斷能力與Holter相當，借助網(wǎng)絡(luò)傳輸，可及時指導(dǎo)患者治療。

Objective To test the clinical value of AKM-N1 type portable remote real-time ECG monitor. Methods Thirty-six patients who were treated in intracardiac department of Beijing Anzhen Hospital from October to November in 2011 were involved in this trial. Arrhythmia was the main manifestation in these patients. There were 21 male cases and 15 female cases, and the average age was 43.0±14.8 years. All the patients underwent real-time ECG test and Holter monitor at the same time. The ECG data, including the duration of P wave, PR interval, QRS duration, QT interval, RR interval, artifacts, interference and arrhythmia type, were compared. The parameters of the two groups in the same time-point were selected, including the 10th min, 20th min, 30th min, 40th min and 50th min after beginning, as well as two time-points when the “capture key” were pressed synchronously as subjects had heart discomfort or just after the instruction of doctors. Results Arrhythmia was detected in 29 cases. There was no difference in ECG parameters of the two methods and the arrhythmia detection rate of the two methods was highly associated (P<0.001). There was no difference in the proportion of arrhythmia (P=1.0). The relevance of the two methods for detecting spuriousity and interference was not certain, yet the ratio had no difference. There was no adverse reaction in this trial. Conclusions AKM-N1 type portable remote real-time ECG monitor can provide accurate ECG data. The value on arrhythmia diagnosis is equal to that of Holter. Doctors can get the patients’ information and give them therapy advice on time with internet.

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