远程心电网络系统对边远少数民族地区基层患者预后不良型室性早搏诊断的应用

Telemedicine ECG system in diagnosis of unfavourable prognostic premature ventricular beats in primary patients in remote

目的:探讨远程心电网络系统对边远少数民族地区基层患者预后不良型室性早搏诊断应用价值。方法:随机选择湖南省张家界市下属三个乡镇中心卫生院主诉心悸患者为研究组,长沙市下属三个街道卫生服务中心主诉心悸患者为对照组,每组3 800例。分别比较两组各类型预后不良型室性早搏检出率的差异,两组预后不良型室性早搏患者在性别和不同年龄段上分布的差异,以及两组预后不良型室性早搏的发生与年龄的相关性。结果:研究组复杂室性早搏检出率高于对照组,差异具有统计学意义(P<0.05),而其他类型预后不良型室性早搏检出率差异无统计学意义(P>0.05)。研究组45~59岁年龄段预后不良型室性早搏患者的检出率明显高于对照组(P<0.05),不同性别及其他年龄段的检出率比较,差异无统计学意义(P>0.05)。两组预后不良型室性早搏的发生与年龄虽呈正相关(P<0.05),但相关度极小。结论:远程心电网络系统有助于边远少数民族地区基层患者预后不良型室性早搏的早期诊断及提高阳性检出率,并辅助筛查预后不良型室性早搏高危人群,从而及早预警院外恶性室性心律失常导致的心源性猝死。

Objective:To explore the application value of telemedicine ECG system in the diagnosis of unfavourable prognostic premature ventricular beats in primary patients in remote. Methods: The patients with palpitations in the three township central health centers in Zhangjiajie City of Hunan Province were randomly selected as the research group and the patients with palpitations in the three sub-district health service centers in Changsha City as the control group, 3 800 cases in each group. The difference of detection rate of various types of unfavourable prognostic premature ventricular beats between the two groups, the difference of distribution of patients in gender and different age groups, and the correlation between the occurrence of unfavourable prognostic premature ventricular beats and age in the two groups were compared and analyzed. Results: The detection rate of complex premature ventricular beats in the study group was higher than that in the control group(P<0.05), while there was no significant difference in the detection rate of other types of premature ventricular beats with poor prognosis(P>0.05).The detection rate of patients with unfavourable prognostic premature ventricular beats in the study group was significantly higher than that in the control group at 45-59 years old(P<0.05), but there was no significant difference in the detection rate among different genders and other ages(P>0.05). The incidence of premature ventricular beats with poor prognosis in the two groups was positively correlated with age(P<0.05), but the correlation was minimal.Conclusion: The telemedicine ECG system is helpful for the early diagnosis of premature ventricular beats with poor prognosis and the improvement of positive detection in primary patients in remote minority areas, and assists in screening high risk population of premature ventricular beats with poor prognosis, so as to early warning sudden cardiac death caused by out-of-hospital malignant arrhythmia.