摘要
目的探讨可穿戴12导联长程间断负荷动态心电检测(简称新型心电检测)应用于招飞选拔的可行性和诊断价值,阐明传统招飞心电检测与新型心电检测在招飞医学选拔中的检出差异。方法根据现行《空军招收飞行学员体格检查标准》《空军招收飞行学员体格检查办法》,从2020年参加空军招飞定选的学生中选取278名作为研究对象,进行可穿戴12导联24 h间断负荷(佩戴参加招飞心理选拔)动态心电检测,检测结束后对其舒适度进行调查、对信号数据质量进行评估并比较两种检测结果的差异。结果新型心电检测采集到最慢心率(42.12±4.66)次/min、最快心率(199.01±13.87)次/min、平均心率(89.28±8.91)次/min。各状态下的心电图(ECG)数据:220例(79.14%)受检者无明显不适,未出现电极完全脱落情况,剧烈运动时181例(65.1%)出现肌电噪声(EMG noise)、108例(38.9%)出现基线漂移;以新型心电检测为标准,传统方法心电异常检测诊断敏感性为10.20%(20/196),特异性为98.78%(81/82),诊断准确率为36.33%[(20+81)/278];新型心电检测采集心电异常检出率为70.5%,95%置信区间为(64.76,75.80),传统心电检测采集心电异常检出率为7.55%,95%置信区间为(4.74,11.32)。结论相较于空军招飞医学选拔传统心电检测,新型心电检测定位准确,图像质量可靠,应用可行,能有效降低招飞医学选拔心电异常的漏诊率。
Objective To study the difference in detection rates between traditional electrocardiogram(ECG)and 12 lead long-range intermittent load dynamic ECG(New ECG detection for short)and to explore the feasibility and diagnostic value of the New ECG detection pilot recruitment.Methods According to"Physial Examination Standards for Pilot Recruitment of Air Force"and"Physical Examination Methods for Pilot Recruitment of Air Force",278 volunteers were selected from students who participated in the pilot recruitment of Air Force in 2020.Apart from traditional ECG examination,these volunteers were subjected to wearable 12 lead detection.The comfort degree,data collection quality and the difference between these two examination methods were investigated.Results The recorded lowest heart rate was(42.12±4.66)bpm,the fastest heart rate was(199.01±13.87)bpm,the average heart rate was(89.28±8.91)bpm in these volunteers.No electrode fell off,and none of the 220 subjects(79.14%)showed any discomfort.During intensive exercise,EMG noise was observed in 181 subjects(65.1%),while baseline drift existed in 108 subjects(38.9%).With the New ECG detection as the standard,the sensitivity,specificity and accuracy of traditional ECG were 10.20%(20/196),98.78%(81/82)and 36.33%[(20+81)/278]respectively.The abnormal detection rate of the New ECG detection was70.5%,and 95%confidence interval was(64.76,75.80),compared to 7.55%and(4.74,11.32)for traditional ECG.Conclusion New ECG detection shows advantages over traditional ECG in positioning,image quality and applicability,which can effectively reduce the missed diagnosis rate of ECG examination in medical selection of Air Force pilots.
作者
张艺耀
张建玲
王雪峰
王伟
周延召
于东睿
张家康
王建昌
史磊
田建伟
邹志康
ZHANG Yi-yao;ZHANG Jian-ling;WANG Xue-feng;WANG Wei;ZHOU Yan-zhao;YU Dong-rui;ZHANG Jia-kang;WANG Jian-chang;SHI Lei;TIAN Jian-wei;ZOU Zhi-kang(Air Force Medical Center,Beijing 100142,China;Air Force Recruitment Bureau,Beijing 100195,China;Institute of Military Cognition and Brain Sciences,Academy of Military Medical Sciences,Academy of Militiiry Sciences,Beijing 100850,China;Department of Outpatients,Air Force Aviation University,Changchun 130000,China)
出处
《军事医学》
CAS
2021年第7期526-530,共5页
Military Medical Sciences
基金
全军后勤科研重点课题(BKJ15J006,BKJ16J012)
国防科技创新特区联合创新项目(1816315ZT00102,2016315ZT00108)。
关键词
可穿戴动态心电设备
心电描述术
便携式
招飞医学选拔
心功能检测
wearable dynamic ECG monitoring system
electrocardiography
ambulatory
pilot recruitment medical examination
cardiac function examination
作者简介
张艺耀,女,硕士,研究方向:飞行人员医学选拔,E-mail:705534469@qq.com;通讯作者:邹志康,Tel:010-66927012,E-mail:zouzhikang1979@126.com。
