diff --git a/crates/erp-health/src/module.rs b/crates/erp-health/src/module.rs
index a1907d4..a3757ff 100644
--- a/crates/erp-health/src/module.rs
+++ b/crates/erp-health/src/module.rs
@@ -134,6 +134,49 @@ impl HealthModule {
         })
     }
 
+    /// 启动 AI 主动巡检（每 24 小时运行一次），扫描有异常数据的患者并发布 AI 分析请求事件
+    pub fn start_ai_patrol(
+        db: sea_orm::DatabaseConnection,
+        event_bus: erp_core::events::EventBus,
+    ) -> tokio::task::JoinHandle<()> {
+        tokio::spawn(async move {
+            // 首次延迟 10 分钟启动，等待其他服务就绪
+            tokio::time::sleep(std::time::Duration::from_secs(600)).await;
+            let mut interval = tokio::time::interval(std::time::Duration::from_secs(24 * 3600));
+            loop {
+                tokio::select! {
+                    _ = interval.tick() => {
+                        match crate::service::stats_service::get_patrol_candidates(&db).await {
+                            Ok(patients) => {
+                                tracing::info!(count = patients.len(), "AI 主动巡检：发现待分析患者");
+                                for (tenant_id, patient_id, doctor_id, reason) in &patients {
+                                    let patrol_event = erp_core::events::DomainEvent::new(
+                                        "ai.patrol.requested",
+                                        *tenant_id,
+                                        erp_core::events::build_event_payload(serde_json::json!({
+                                            "patient_id": patient_id.to_string(),
+                                            "doctor_id": doctor_id.map(|d| d.to_string()),
+                                            "source": "daily_patrol",
+                                            "reason": reason,
+                                        })),
+                                    );
+                                    event_bus.publish(patrol_event, &db).await;
+                                }
+                            }
+                            Err(e) => {
+                                tracing::warn!(error = %e, "AI 主动巡检：获取待分析患者失败");
+                            }
+                        }
+                    }
+                    _ = tokio::signal::ctrl_c() => {
+                        tracing::info!("AI 主动巡检任务收到关闭信号，正在停止");
+                        break;
+                    }
+                }
+            }
+        })
+    }
+
     pub fn public_routes<S>() -> Router<S>
     where
         crate::state::HealthState: axum::extract::FromRef<S>,
@@ -473,6 +516,10 @@ impl ErpModule for HealthModule {
         let _daily_agg_handle = Self::start_daily_aggregation(ctx.db.clone());
         tracing::info!(module = "health", "Daily aggregation task started");
 
+        // 启动 AI 主动巡检（每天扫描异常患者，发布 ai.patrol.requested 事件）
+        let _patrol_handle = Self::start_ai_patrol(ctx.db.clone(), ctx.event_bus.clone());
+        tracing::info!(module = "health", "AI patrol task started");
+
         Ok(())
     }
 
diff --git a/crates/erp-health/src/service/stats_service/mod.rs b/crates/erp-health/src/service/stats_service/mod.rs
index 699c4d1..b846c15 100644
--- a/crates/erp-health/src/service/stats_service/mod.rs
+++ b/crates/erp-health/src/service/stats_service/mod.rs
@@ -31,3 +31,47 @@ pub use dashboard::get_module_status;
 pub use dashboard::get_points_recent_activity;
 pub use dashboard::get_system_health;
 pub use dashboard::get_user_activity;
+
+// ── AI 主动巡检 ──
+use sea_orm::{ColumnTrait, DatabaseConnection, EntityTrait, QueryFilter, QueryOrder};
+use uuid::Uuid;
+
+/// 获取 AI 主动巡检候选患者：最近 7 天有异常告警但未做 AI 分析的患者
+pub async fn get_patrol_candidates(
+    db: &DatabaseConnection,
+) -> Result<Vec<(Uuid, Uuid, Option<Uuid>, String)>, sea_orm::DbErr> {
+    let seven_days_ago = chrono::Utc::now() - chrono::Duration::days(7);
+
+    // 查找最近 7 天有告警记录的患者（去重，每个患者取最新一条）
+    let alerts = crate::entity::alerts::Entity::find()
+        .filter(crate::entity::alerts::Column::CreatedAt.gte(seven_days_ago))
+        .filter(crate::entity::alerts::Column::DeletedAt.is_null())
+        .filter(crate::entity::alerts::Column::Status.is_in(["active", "acknowledged", "new"]))
+        .order_by_desc(crate::entity::alerts::Column::CreatedAt)
+        .all(db)
+        .await?;
+
+    // 按患者去重，保留最新告警
+    let mut seen = std::collections::HashSet::new();
+    let mut candidates = Vec::new();
+    for alert in alerts {
+        if seen.contains(&alert.patient_id) {
+            continue;
+        }
+        seen.insert(alert.patient_id);
+
+        // 查找管床医生
+        let doctor = crate::entity::patient_doctor_relation::Entity::find()
+            .filter(crate::entity::patient_doctor_relation::Column::PatientId.eq(alert.patient_id))
+            .filter(crate::entity::patient_doctor_relation::Column::TenantId.eq(alert.tenant_id))
+            .filter(crate::entity::patient_doctor_relation::Column::DeletedAt.is_null())
+            .one(db)
+            .await?
+            .map(|r| r.doctor_id);
+
+        let reason = format!("告警未处理: {} (severity: {})", alert.title, alert.severity);
+        candidates.push((alert.tenant_id, alert.patient_id, doctor, reason));
+    }
+
+    Ok(candidates)
+}