应用分时段无线传输的Holter心电监护系统诊断急性冠脉综合征

Diagnostic value and clinical significance of telemetry Holter electrocardiogram monitoring system in patients with acute coronary syndrome

目的探讨分时段无线传输的Holter心电监护对急性冠脉综合征(acute coronary syndrome,ACS)的诊断价值及临床意义。方法分时段无线传输Holter心电监护通过对波形分析的自感应和报警按钮双重作用向分析中心发送心脏事件预警,分析中心医师通过其实时心电图与其前心电图对比分析作出ACS的诊断;分析检出的66例ACS患者的基本情况,以及就检地点和记录盒佩戴时间。结果 3年中共有246例疑诊冠心病患者接受分时段无线传输的Holter心电监护检查,从中检出ACS66例,占26.8%,其中急性心肌梗死39例,占59.1%,心绞痛27例,占40.9%。到医院就检的53例,检出ACS14例,占26.4%;在基层医疗点受检193例,检出ACS42例,占21.8%。基层医疗点无论是受检人数还是ACS检出人数都明显多于到医院就诊者(193/53,3.64∶1,42/14,3∶1)。在检出的66例ACS者中,Holter监护时间为52分～22小时46分,均提前结束预设监护时间,为早期治疗赢得宝贵时间。结论分时段无线传输的Holter心电监护可及时发现和确诊ACS,弥补了Holter心电监护只能作回顾性分析的缺陷,在及时治疗、减少严重并发症、提高救治质量以及改善预后方面有十分重要的临床实用价值。

Objective To discuss the diagnostic value and clinical significance of wireless and intermittent Holter monitoring system for acute coronary syndrome(ACS). Methods A total of 246 patients were investigated by using a telemetric Holter system, intermittent transmission of ECG data.The clinical characteristics of the patients, who were diagnosed ACS by digital Holter recording were analyzed, and compared with conventional Holter examination. Results There were 66 out of 246 patients(66/246,26.8%)diagnosed ACS by digital Holter recordings. Among 66 cases with ACS,there were 39 cases with acute myocardial infarction(39/66,59.1%),27 angina pectoris(27/66,40.9%). Compared with the detection rate of ACS in hospital(14/53,26.4%),the primary medical organizations had higher detection rates (142/193,21.8%). In the 66 patients with ACS, Holter monitoring time was 52 minutes -22 hours 46 minutes, all in the default monitoring time. Conclusion Patients with ACS could be confirmed by wireless intermittent Holter transmission, which remedies conventional Holter′s defects that it could only make retrospective analysis. Meanwhile, it had very important clinical application value in giving prompt treatment, reducing complications and improving the quality of treatment and prognosis.