上海市成年社区人群主要心电图异常的特点及其影响因素  

Epidemiological characteristics of major abnormal electrocardiogram in adults from Shanghai

作　　者：刘宇[1,2] 侯旭宏[2] 胡伟国[2] 陆惠娟[2] 马晓静[2] 贾伟平[2] 

机构地区：[1]苏州大学医学部,215000 [2]上海市第六人民医院

出　　处：《中华流行病学杂志》2013年第5期451-456,共6页Chinese Journal of Epidemiology

摘　　要：目的评估上海市成年社区人群主要心电图异常（MA—ECG）患病率及其特点，并分析其主要影响因素。方法利用2007--2008年上海市20～74岁成人糖尿病及代谢综合征患病率横断面调查资料。调查内容包括人口学资料、相关病史、家族病史、体格和实验室检查。调查对象检查静息12导联心电图，采用明尼苏达标准编码，并依据Pooling Project方案分为MA．ECG和非MA—ECG。结果共5364（男性2003、女性3361）人纳入分析。（1）总人群MA—ECG标化患病率为7．3％，其中男性为7．0％，女性为7．7％。无论男女，年龄别MA—ECG患病率均随年龄增长而显著增加。男性青年、中年和老年人群的MA．ECG标化患病率依次为2．3％、7．7％和17．3％；女性青年、中年和老年人群的MA．ECG标化患病率依次为3．3％、8．8％和16．4％（趋势分析P值均〈0．01）。（2）男性中MA—ECG常见类型为心律失常（28．8％）、束支传导阻滞（26．5％）和sT段压低（20．0％）；女性分别为sT段压低（44．6％）、心律失常（23．0％）和复合MA—ECG（11．8％）。（3）多因素调整的logistic回归分析表明，除年龄增加外，冠心病为男性MA．ECG的独立危险因素（OR=2．33。2．39）；女性中绝经（OR=1．72～1．85）、高血压（OR=1．33～1．34）分别为MA—ECG的独立危险因素。结论上海市成年社区人群MA．ECG患病率较高，心律失常和sT段压低是最常见类型，年龄增加、冠心病、女性绝经和高血压是MA—ECG的主要影响因素。Objective To understand the prevalence, characteristics and risk factors of major abnormal electrocardiogram （MA-ECG） in adults living in Shanghai. Methods The cross- sectional dataset of prevalence survey on diabetes and metabolic syndrome in adults, aged 20-74 years, from Shanghai, in 2007-2008, was analyzed. Demographic information, personal and, family histories of diseases were collected. Physical examination and laboratory tests were done. Subjects underwent examination on resting 12-leads electrocardiogram （ECG）, ECG records were coded according to the Minnesota criteria and classified as MA-ECG or non-MA-ECG. Results A total number of 5364 subjects （2003 men, 3361 women） were finally included in this analysis. （1） The standardized prevalence of MA-ECG was 7.3% （7.0% in men, 7.7% in women）. In both genders, the age-specific prevalence of MA-ECG significantly increased with age （P〈0.01）. The age-specific prevalence of MA-ECG in youths, middle aged and the elderly were 2.3%, 7.7%, and 17.3% in men, and 3.3%, 8.8% and 16.4% in women, respectively （both P^o~d〈0.01）. （2） The three most common MA-ECG forms were arrhythmia （28.8%） ,bundle branch block （26.5%） and ST segment depression （20.0%） in men, while there appeared ST segment depression （44.6%）, arrhythmia （23.0%） and combined MA-ECG （11.8%） in women. （3） Data from multivariate logistic regression analysis showed that other than age, coronary heart disease （CHD） was the only independent risk factor of MA-ECG in men, with its corresponding OR being 2.33-2.39; while in women, menopause （OR value： 1.72-1.85） and hypertension （OR value： 1.33-1.34） were main factors related to MA-ECG. Conclusion MA-ECG was prevalent in the middle aged and the elderly, with, arrhythmia and ST segment depression the most frequent forms of MA-ECG. Age, CHD and hypertension were the main risk factors of MA-ECG in the adults from Shanghai.

关 键 词：主要心电图异常 明尼苏达编码 横断面研究 

分 类 号：R54[医药卫生—心血管疾病] R589[医药卫生—内科学]