农村远程心电监测心肌梗死的临床分析

Clinical analysis on rural remote ECG monitoring myocardial infarction

目的探讨农村及社区急性心肌梗死发病及死亡规律。方法采用远程心电监测会诊的方法,入选确诊急性心肌梗死患者65例(监测组),分析入选患者四季及每天时间发病及死亡情况。选择同期门诊确诊的急性心肌梗死21例患者(门诊组),对两组急性心肌梗死的发病情况进行对比分析。结果研究期间共监测、会诊农村及社区远程终点患者心电图14591例,确诊急性心肌梗死65例(0.44),其中5例急性心肌梗死患者死亡,死亡率为7.69(5/65),低于门诊组急性心肌梗死患者的死亡率(14.28,3/21),但两组间的差异并无统计学意义(P>0.05)。农村与社区急性心肌梗死易发时间为冬季(构成比为40)、每天晨起5:00～10:00(构成比为36.9),监测组与门诊组患者急性心肌梗死发病的四季构成比及每天发病的时间构成比,两组间的差异均无统计学意义(P均>0.05)。结论农村及社区急性心肌梗死易发时间为冬季、晨起,远程心电监测对降低急性心肌梗死的死亡率有帮助。

Objective To probe the laws of morbidity and mortality of the patients in rural and community with acute myocardial infarction(AMI).Methods The AMI patients(n=65) diagnosed by Remote ECG Consultation Center were selected as the monitoring group,and AMI patients(n=21) diagnosed in the outpatient department were selected as the outpatient group.The mortality and cases of occurrence in four seasons and every day were compared and analyzed in two groups.Results During the study period,the ECG of 14 591 patients were monitored by Remote ECG Consultation Center,and 65 patients(0.44%) were diagnosed as AMI.There were 5 cases(7.69%,5/65) died in the monitoring group and 3(14.28%,3/21) died in the outpatient group,but the difference between the two groups was not statistically significant(P>0.05).AMI in rural and community prone to occur in the winter(composition ratio was 40%),and morning 5:00~10:00(composition ratio was 36.9%).Conclusion The study showed that AMI in rural and community usually occurs in winter and morning.remote ECG monitoring maybe helpful to reduce mortality in AMI.