远程实时心电监测仪与常规心电图在心血管疾病中的监测和对比分析

目的通过对远程实时心电监测仪进行性能测试和临床应用研究，旨在评价远程监测仪记录心电信号的准确性、安全性和有效性，并探讨其临床应用价值。方法人选2008年4月至2008年12月北京阜外心血管病医院194例住院患者。所有受试者均进行远程实时心电监测仪（心电手机）及常规12导联心电图监测，分为远程心电图组及常规心电图组。对两组进行心电图诊断及时间和幅度参数的比较。结果远程心电图组胸前导联的图形质量及基线稳定性相对优于肢体导联。经比较远程心电图组心律失常检出率高（P〈0．05），共识别出心律失常266例，其中，快速心律失常135例，缓慢心律失常131例，最常见心律失常依次是室性早搏（18．7％），一度房室阻滞（13．9％）及心房颤动（13．5％）。两组仪器所测得正常心电图组在心率、P波、PR间期、QRS时限、QT间期等参数间差异均无统计学意义，参数相关良好；V2、V3、V5及I导联进行P波振幅、QRS波振幅、QRS综合压代数和压差及T波振幅等参数之间比较差异无统计学意义。结论远程实时心电监测仪心电信号记录准确，能够检测出常见的心律失常及恶性室性心律失常，对心律失常的诊断符合率高，使用可靠、安全。

Evaluation of a remote real-time electrocardiogram monitoring system in patients with cardiovascular disease

Objective A remote real-time wireless electrocardiography monitoring system based on GPRS was evaluated and to compare the accuracy and stability of electrocardiosignal with the 12 leads electrocardiogram(ECG). Methods The data were collected from 194 in-patients from April 2008 to December 2008in Fuwai hospital. All subjects were received the remote real-time ECG monitoring and the 12 leads ECG, and these patients were divided into two groups. The aspects of ECGs were compared between the two systems including the general waves, clinical diagnosis, time and voltage parameters. Result In remote ECG groups, the baseline stability of precordial leads was better than limb leads. Compare to 12 leads ECG,detectable rate of arrhythmia was higher in remote ECG groups,and it identified 266 cases of arrhythmia,including 135 cases of tachyarrhythmia and 131 cases of bradyarrhythmia. The most common arrhythmia was ventricular premature beat (18. 7% ),one degree atrioventricular block was the second (13.9%)and atrial fibrillation was the third ( 13.5% ). There were no significant difference in the time parameters between the two systems,and was significant correlation. The voltage parameter of the two systems was no significant difference. Conclusion The accuracy and stability of the remote real-time ECG monitoring system based on GPRS is in accordance with the standard ECG instrument. The remote real-time electrocardiogram monitoring system may be a helpful tool in assisting physicians in the diagnosis of common arrhythmia and malignant ventricular arrhythmia disorders, and showed high safety in data recording.