健康管理人群缺血性异常心电图的影响因素  

The influencing factors of ischemic ECG abnormalities in a large health check-up population

作　　者：李江冰[1] 宋心红[2] 林海燕[2] 张冬芝[2] 李向一[3,4] 许艺博 王丽 薛付忠[3,4] 

机构地区：[1]山东大学附属省立医院心内科,山东济南250021 [2]山东大学附属省立医院健康查体中心,山东济南250021 [3]山东大学公共卫生学院生物统计学系,山东济南250012 [4]山东大学齐鲁生物医学大数据研究中心,山东济南250012 [5]山东电力中心医院心内科,山东济南250001

出　　处：《山东大学学报（医学版）》2017年第6期77-81,86,共6页Journal of Shandong University:Health Sciences

基　　金：国家自然科学基金(81273177);山东省医药卫生科技发展计划项目(2013WS0230)

摘　　要：目的阐明健康管理人群的缺血性异常心电图的影响因素及非缺血性异常心电图对重要的缺血性异常心电图的预测价值。方法选择山东多中心健康管理纵向观察队列中至少参加2次体检的个体,排除冠心病及缺血性异常心电图患者,构建随访队列。对随访中发生缺血性异常心电图者与未发生缺血性异常心电图者,比较其基线信息,并筛选影响缺血性异常心电图的危险因素,进一步构建缺血性异常心电图的Cox回归分析模型。结果队列中共纳入45 546例,随访时间1~7年,平均3.24年,随访中共有7 656例出现缺血性异常心电图,发病密度为77.57/1 000人年。缺血性异常心电图发生的主要影响因素是年龄偏高、女性、高收缩压和舒张压、高空腹血糖、白细胞计数高以及非缺血性异常心电图R波高电压。结论本研究探讨导致缺血性异常心电图的危险因素,为制定切实可行的健康干预措施提供了科学依据。Objective To explore the influencing factors of ischemic electrocardiogram （ECG） abnormalities and the pre- dictive value of non-ischemic ECG among the health check-up population. Methods Individuals who had taken at least 2 health check-ups during 21304 and 2014 were selected from the Shandong Multi-center Longitudinal Cohort for Health Manage- ment. Those who suffered coronary heart disease and presented with ischemic ECG were excluded. The baseline information of subjects who showed ischemic ECG during the follow-up was compared with who showed no ischemic ECG. The risk fac- tors of ischemic ECG were screened and the Cox regression analysis model was established. Results The cohort included 45 546 subjects. During the follow-up of 1-7 years （ mean 3.24 years ）, 7 656 individuals presented with ischemic ECG abnor- malities. The incidence density was 77.57/1 0190 person-year. The main influencing factors of ischemic ECG included old age, female, high systolic pressure and diastolic pressure, high fasting blood glucose （FBG）, high white blood cell count, and non-ischemic abnormal high amplitude R waves （MC-3）. Conclusion This study investigated the risk factors leading to ischemic ECG abnormalities and provided scientific information for the intervention of heart diseases.

关 键 词：缺血性异常心电图 影响因素 队列研究 健康管理人群 健康体检大数据 

分 类 号：R587.1[医药卫生—内分泌]