摘要
目的探讨新型植入型心电监测仪（ICM）的临床应用及其对晕厥和心律失常的诊断价值。方法连续入选2015年9月至2017年7月在新疆医科大学第一附属医院植入ICM（Reveal LINQTM，美国美敦力公司）的患者52例，男32例，女20例，平均年龄（51．92±16．24）岁。其中，34例晕厥待查患者植入前平均晕厥（2．17±0．41）次。所有患者均行ICM植入术，术后通过事件激活和自动记录两种方式规律随访，分析心律失常事件的检出情况。结果植入前患者首诊科室：急诊11例、神经内科17例、晕厥门诊7例、心脏内科17例；患者平均就诊（4．52±2．66）次；平均行（8．26±1．79）项检查；人均检查花费（5493．36±3098．06）元人民币。相较于首诊于晕厥门诊的患者，首诊于其他科室患者就医次数、检查项目数量及费用增加，植人设备时间延长[（1．86±0．95）次对（4．91±2．73）次；（5．83±1．17）项对（8．61±1．58）项；（2016．33±385．25）元对（6002．2±2990．03）元；（60．00±37．13）d对（153．75±43．23）d，P〈0．05]。植入后5例患者失访，其余47例患者完成随访，平均随访（305．87±102．07）d。随访期间，共检出心律失常26例，其中心脏停搏8例、缓慢性心律失常6例、快速性心律失常12例（包括心房颤动3例），共21例患者未检出心律失常。事件激活和自动记录两种监测方式的心律失常检出率差异无统计学意义（58．06％对50％，P=0．76）。相较于植入〈1年的患者，植入≥1年的患者心律失常检出率高（29．41％对70％，P=0．007）。术中及随访期间无并发症发生。结论ICM对不明原因晕厥、心悸患者病因诊断和制定进一步治疗提供了可靠的诊断依据。
Objective To investigate the clinical application of the insertable cardiac monitor （ ICM ） in the patients with syncope or cardiac arrhythmia. Methods From September 2015 to July 2017, 52 patients [ 32 male, mean age： （ 51.92 ± 16.24 ） years old implanted ICM device （ Reveal LINQTM ） were enrolled in this study. The average syncope time was 2.17 ± 0.41 in the 34 patients with syncope. All patients underwent implantation of ICM. The follow-up of arrhythmia events after implantation were analyzed by event activation and automatic recording. Results Among the patients, 11 cases first visited in the emergency department, 17 cases were first visited in the neurology department, seven cases were first visited in the syncope department and 17 cases were first visited in the cardiac department. The average visiting was （ 4.52 ± 2.66 ） times, the average examination was （ 8.26 ± 1.79 ） items and the average cost was ￥ （ 5 493.36 ± 3 098.06 ）. Compared with the patients who were first visited syncope department, the visit times [ （ 1.86 ± 0.95 ） vs. （ 4.91 ± 2.73 ）, P〈0.05 ], examination items [ （ 5.83 ± 1.17 ） vs. （ 8.61 ± 1.58 ）, P〈0.05 ） and cost[ （ 2 016.33 ±385.25 ） vs. ￥（ 6 002.2 ± 2 990.03 ）, P〈0.05 ] were higher and time from first visit to implantation [ （ 60.00 ± 37.13 ） d vs. （ 153.75 ± 43.23 ） d,P〈0.05 ] was prolonged in the other departments. The follow-up was conducted in 47 eases.
作者
赵阳
商鲁翔
周贤惠
李耀东
张疆华
邢强
芦颜美
张玲
汤宝鹏
Zhao Yang, Shang Luxiang, Zhou Xianhui, Li Yaodong, Zhang Jianghua, Xing Qiang, Lu Yanmei, Zhang Ling, Tang Baopeng.(Department of Pacemaker and Electrophysiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Chin)
出处
《中华心律失常学杂志》
2018年第1期31-35,共5页
Chinese Journal of Cardiac Arrhythmias
基金
国家自然科学基金（81570297）
新疆维吾尔自治区科技计划项目（201517101）
关键词
植入型心电监测仪
晕厥
心律失常
临床应用
Insertable cardiac monitor
Syncope
Cardiac arrhythmia
Clinical application
