远程心电监测心电图危急值的临床影响因素分析

Clinical influencing factor analysis of ECG critical value by remote ECG monitoring

目的通过远程心电监测检测出有危急值的心电图,分析其是否与部分临床因素有关。方法选取我院住院患者共180例,入院后第2天均佩戴心脏实时监护预警机,佩戴时间为24 h;按照有无危急值预警分为有危急值组(73例)和无危急值组(107例),分析出现危急值预警时各临床因素是否对其产生影响。结果单因素分析表明,年龄、房颤、高血压、脑卒中、血脂异常、脑钠肽升高与危急值的出现无明显相关性(P>0.05)。多因素分析显示,以女性危急值的发生率是100%(OR=1.000)为参照,男性危急值的发生率是43.5%(OR=0.435,95%CI 0.228~0.829,P=0.011),女性与危急值的出现相关性较大;以糖尿病患者危急值的发生率是100%(OR=1.000)为参照,无糖尿病者危急值发生率为36.9%(OR=0.369,95%CI 0.163~0.803,P=0.012),患有糖尿病与危急值的出现相关性较大。结论女性及患有糖尿病是出现危急值的独立影响因素。

Objective To detect electrocardiograms(ECGs)with critical value by remote ECG monitoring and to analyze its association with a part of clinical factors.Methods A total of 180 inpatients in our hospital were selected;they all wore heart real-time monitoring and warning machine for 24 hours on the second day after admission.The research subjects were divided into critical-value group(73 cases)and non-critical-value group(107 cases)according to the absence or presence of critical value warning.We analyzed whether each clinical factor would affect critical value warning.Results Monofactor analysis significantly shows no correlation between age,atrial fibrillation,hypertension,cerebral apoplexy,dyslipidemia,elevation of brain natriuretic peptide and the emergence of critical value(P>0.05).Multivariate analysis implies the incidence of critical value in males is 43.5%(OR=0.435,95%CI 0.228-0.829,P=0.011)if females'is referred to as 100%(OR=1.000).It suggests female sex is closely associated with the presence of critical value.If the incidence of critical value in diabetics is referred to as 100%(OR=1.000),the incidence of non-diabetes cases is 36.9%(OR=0.369,95%CI 0.163-0.803,P=0.012).It suggests suffering from diabetes is closely associated with the emergence of critical value.Conclusion Female sex and complication by diabetes are independent influencing factors of the presence of critical value.