摘要
背景心律失常发生率高且严重威胁人类健康,但由于其症状的隐匿性和发作的不可预测性,传统的心电设备很难捕捉到发作时心电图,无法得以确诊和对因治疗。在社区医生指导下,居民居家自行应用单导联可穿戴心电设备采集数据并实时上传可以明显提升心律失常的诊断率,但目前国内外相关研究大多缺乏真实世界数据的支撑。目的探讨基于社区移动医疗的3种心律失常筛查方案的真实世界研究。方法选取2020年9月至2021年9月银川市所属社区纳入的435例居民作为受试者,根据性别分为男性组(177例)、女性组(258例);根据年龄分为青年组(135例)、中年组(200例)、老年组(100例);根据受教育程度分为小学组(77例)、中学组(165例)、大学组(193例);根据既往有无明确心血管病病史分为有病史组(233例)和无病史组(202例)。应用单导联可穿戴远程心电设备,分别按以下方案采集心电数据:间断采集3次24 h心电数据(方案1);采集1次24 h及至少3次1 h心电数据(方案2);连续采集1次72 h及至少1次1 h心电数据(方案3)。由受试者自主自愿选择筛查方案中的任意1种,不论有无症状均自主选择时间,自行佩戴单导联可穿戴远程心电设备采集心电数据并上传至云平台。统计选择3种筛查方案的受试者数量、不同分组与方案选择的相关性,及3种筛查方案的心律失常检出率。结果选择3种筛查方案的受试者分别为321、40、74例。其中3种筛查方案受试者平均年龄比较,差异有统计学意义(P=0.047);受试者性别、受教育程度、有/无病史与方案选择无相关性(χ^(2)=0.670,P=0.715;χ^(2)=2.994,P=0.559;χ^(2)=2.225,P=0.893);不同年龄分组与方案选择有相关性(χ^(2)=9.939,P=0.041)。3种筛查方案心律失常的检出率分别为85.67%、82.50%、85.14%,差异无统计学意义(χ^(2)=0.286,P=0.867);男性组、女性组受试者的3种筛查方案心律失常检出率比较,�
Background Arrhythmia has a high incidence,and is a serious threat to human health.However,due to concealed symptoms and unpredictability of onset,it is difficult for traditional ECG equipment to capture the ECG data at the onset of the arrhythmic events,so it could be misdiagnosed and under-treated.Fortunately,the diagnosis rate of arrhythmia could be greatly enhanced by analyzing the uploaded real-time ECG data of individuals measured at home using the wearable single-lead ECG monitoring system under the guidance of community doctors,but there is a lack of relevant evidence from real-world studies.Objective To assess the diagnostic accuracies of three schemes for screening arrhythmia in the community using a wearable single-lead ECG monitoring system.Methods A real-world,community-based study design was used for comparing three schemes for screening arrhythmia using a wearable single-lead ECG monitoring system:scheme 1 was used for collecting 24-hour ECG data on any three nonconsecutive days in two weeks,scheme 2 was used for collecting 24-hour ECG data on any day and at least three 1-hour ECG data in two weeks,and scheme 3 was adopted for collecting 72-hour ECG data on any three consecutive days and at least one 1-hour ECG data on any one day in two weeks.Subjects were 435 community-living residents,who were recruited from Yinchuan from September 2020 to September 2021.They were divided into male group(177 cases),female group(258 cases);young group(135 cases),middle-aged group(200 cases)and elderly group(100 cases)by age;primary school group(77 cases),middle school group(165 cases)and university group(193 cases)by educational level;arrhythmia group(233 cases)and non-arrhythmia group(202 cases)by the history of arrhythmia.Subjects measured the ECG either at the onset time of perceived arrhythmia or not using any one of the three screening schemes chosen voluntarily with the wearable single-lead ECG monitoring system,then uploaded the measurement results to the cloud platform.The number of participants using eac
作者
余新艳
赵旭东
赵晓晔
刘海鹏
姜清茹
张海澄
YU Xinyan;ZHAO Xudong;ZHAO Xiaoye;LIU Haipeng;JIANG Qingru;ZHANG Haicheng(Health Management&Physical Examination Center,the First People's Hospital of Yinchuan,Yinchuan 750001,China;Xinhua Subdistrict Community Health Center,the First People's Hospital of Yinchuan,Yinchuan 750001,China;School of Electrical and Information Engineering,North Minzu University,Yinchuan 750021,China;Center for Intelligent Healthcare,Coventry University,Coventry CV15FB,UK;Department of Cardiology,Peking University People's Hospital,Beijing100044,China)
出处
《中国全科医学》
CAS
北大核心
2023年第2期192-200,209,共10页
Chinese General Practice
基金
国家社会科学基金重大项目(18ZDA086-4)
宁夏自然科学基金资助项目(2022AAC03242)
银川市科技创新重点重大专项(2021-SF-009)。
