diff --git a/crates/erp-health/src/event.rs b/crates/erp-health/src/event.rs
index ff69ff8..10cea41 100644
--- a/crates/erp-health/src/event.rs
+++ b/crates/erp-health/src/event.rs
@@ -825,4 +825,81 @@ pub fn register_handlers_with_state(state: crate::state::HealthState) {
             }
         }
     });
+
+    // lab_report.uploaded → 触发 AI 自动分析
+    let (mut lab_upload_rx, _lab_upload_handle) = state.event_bus.subscribe_filtered("lab_report.".to_string());
+    let lab_upload_db = state.db.clone();
+    let lab_upload_bus = state.event_bus.clone();
+    tokio::spawn(async move {
+        loop {
+            match lab_upload_rx.recv().await {
+                Some(event) if event.event_type == LAB_REPORT_UPLOADED => {
+                    if erp_core::events::is_event_processed(&lab_upload_db, event.id, "lab_upload_ai_trigger").await.unwrap_or(false) {
+                        continue;
+                    }
+                    let report_id = event.payload.get("report_id").and_then(|v| v.as_str());
+                    let patient_id = event.payload.get("patient_id").and_then(|v| v.as_str());
+                    if let (Some(rid), Some(pid)) = (report_id, patient_id) {
+                        let ai_event = erp_core::events::DomainEvent::new(
+                            "ai.analysis.requested",
+                            event.tenant_id,
+                            erp_core::events::build_event_payload(serde_json::json!({
+                                "source_type": "lab_report",
+                                "source_id": rid,
+                                "patient_id": pid,
+                            })),
+                        );
+                        lab_upload_bus.publish(ai_event, &lab_upload_db).await;
+                        tracing::info!(report_id = rid, patient_id = pid, "化验单上传触发 AI 分析请求");
+                    }
+                    let _ = erp_core::events::mark_event_processed(&lab_upload_db, event.id, "lab_upload_ai_trigger").await;
+                }
+                Some(event) if event.event_type == LAB_REPORT_REVIEWED => {
+                    if erp_core::events::is_event_processed(&lab_upload_db, event.id, "lab_reviewed_notifier").await.unwrap_or(false) {
+                        continue;
+                    }
+                    let patient_id = event.payload.get("patient_id").and_then(|v| v.as_str());
+                    let reviewer_id = event.payload.get("reviewer_id").and_then(|v| v.as_str());
+                    if let (Some(pid), Some(rid)) = (patient_id, reviewer_id) {
+                        let notify = erp_core::events::DomainEvent::new(
+                            "message.send",
+                            event.tenant_id,
+                            erp_core::events::build_event_payload(serde_json::json!({
+                                "channel": "in_app",
+                                "recipient_type": "patient",
+                                "recipient_id": pid,
+                                "template_key": "LAB_REPORT_REVIEWED",
+                                "params": { "reviewer_id": rid }
+                            })),
+                        );
+                        lab_upload_bus.publish(notify, &lab_upload_db).await;
+                        tracing::info!(patient_id = pid, reviewer_id = rid, "化验报告审核通知已发送给患者");
+                    }
+                    let _ = erp_core::events::mark_event_processed(&lab_upload_db, event.id, "lab_reviewed_notifier").await;
+                }
+                Some(_) => {}
+                None => break,
+            }
+        }
+    });
+
+    // patient.updated → 审计日志
+    let (mut patient_update_rx, _patient_update_handle) = state.event_bus.subscribe_filtered("patient.".to_string());
+    let patient_update_db = state.db.clone();
+    tokio::spawn(async move {
+        loop {
+            match patient_update_rx.recv().await {
+                Some(event) if event.event_type == PATIENT_UPDATED => {
+                    if erp_core::events::is_event_processed(&patient_update_db, event.id, "patient_updated_audit").await.unwrap_or(false) {
+                        continue;
+                    }
+                    let patient_id = event.payload.get("patient_id").and_then(|v| v.as_str());
+                    tracing::info!(patient_id = ?patient_id, tenant_id = %event.tenant_id, "患者信息已更新");
+                    let _ = erp_core::events::mark_event_processed(&patient_update_db, event.id, "patient_updated_audit").await;
+                }
+                Some(_) => {}
+                None => break,
+            }
+        }
+    });
 }