上海高行社区老年人束支传导阻滞患病率及其危险因素分析  

Prevalence and risk factors of bundle branch block in elderly population in Shanghai Gao-hang community

作　　者：陈辰 郑亮[1] 刘杰[1] 陈晓丽[1] 孙慧敏 吴宏 兰琴[1] 李怡茜 常欢 范慧敏[1] 刘中民[1] 王虹艳[2] 张玉珍[1] 

机构地区：[1]同济大学附属东方医院,上海200120 [2]大连医科大学附属第二医院,大连116023 [3]上海市高行社区卫生服务中心,上海200150

出　　处：《中国循证心血管医学杂志》2017年第9期1051-1054,1057,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：上海市浦东卫计委优秀青年基金(PWRq2014-01);上海市促进中医药发展三年计划(ZY3-LCPT-2-1003);上海市卫生计生委重大疾病项目拨款项目(2014ZYJB0502);国家自然科学基金会(81370433)

摘　　要：目的分析上海高行社区老年人束支传导阻滞的患病率及其影响因素。方法于2013年6月~10月间对上海市浦东高行社区老年居民进行系统抽样调查,共纳入受试者3950例,男性1745例,女性2205例。根据年龄分为三组:65~69岁(1850例),70~79岁(1492例),≥80岁(608例)。根据束支传导阻滞情况分为:正常组(3717例)、左束支传导阻滞(LBBB)组(53例)、右束支传导阻滞(RBBB)组(180例)。问卷调查收集入选者的一般资料,收集静脉血检测实验室指标,同型半胱氨酸(Hcy)、糖化血红蛋白(Hb A1c)、高密度脂蛋白胆固醇(HDL-C)、血肌酐(Cr)以及检测左室射血分数(LVEF)等。结果随年龄增加,三组空腹血糖、Hcy、Cr和尿酸呈逐渐升高的趋势,差异有统计学意义(P均<0.05)。≥80岁入选者较65~69岁吸烟比例下降,HDL-C、Hb A1c、收缩压、高血压和心血管病比例升高,差异有统计学意义(P均<0.05)。束支传导阻滞总患病率为5.9%,RBBB患病率为4.6%,LBBB患病率则为1.3%。亚组分析:男性RBBB、LBBB患病率均高于女性,5.8%vs.3.6%,1.9%vs.0.9%,差异有统计学意义(P均<0.05);随着年龄升高,LBBB、RBBB患病率均有显著上升趋势,差异有统计学意义(P均<0.05)。与正常组比较,LBBB组和RBBB组年龄、男性比例、Hcy、Cr、尿酸升高,差异有统计学意义(P均<0.05)。LBBB组较正常组高血压、心肌梗死、心脏瓣膜病比例升高,LVEF降低,差异有统计学意义(P均<0.05)。经多因素Logistic回归分析发现,年龄(OR=1.081,95%CI:1.038~1.126)、高血压病(OR=1.973,95%CI:1.007~3.866)、心肌梗死(OR=5.807,95%CI:1.616~20.862)、心脏瓣膜病(OR=5.566,95%CI:1.152~26.892)、性别(OR=2.089,95%CI:1.106~3.945)是高行社区老年居民患有LBBB的危险因素,LVEF(OR=0.968,95%CI:0.937~0.999)为保护因素;年龄(OR=1.079,95%CI:1.053~1.105)、男性(OR=1.608,95%CI:1.102~2.346)是高行社区老年居民患有RBBB的危险因素。结论上海高行社区老年居民束支传导阻滞的总患病�Objective To investigate prevalence and risk factors of bundle branch block （BBB） in elderly population in Shanghai Gao-hang community. Methods We selected the target population through cluster random sampling in the Shanghai Gao-hang community. The clinical baseline data of different age groups and the ratio of different types of bundle branch block were analyzed by using the Chi-square test. The risk factors of left bundle branch block （LBBB） and right bundle branch block （RBBB） were evaluated by logistic regression. Results The prevalence of LBBB was 1.34%, and RBBB was 4.56% in the Gao-hang community in Shanghai. BBB prevalence increased with age increasing. Results of multiple-logistic regression showed that age , male , hypertension, AMI and valvular heart disease are risk factors of LBBB, and the ORs （95%CI） were 1.081 （1.038~1.126）, 2.089 （1.106~3.945）, 1.973 （1.007~3.866）, 5.807 （1.616~20.862）, 5.566 （1.152~26.892） and 0.968 （0.937~0.999）. The age [1.079 （1.053~1.105）], man [1.608 （1.102~2.346）] are risk factors of RBBB. Conclusions The prevalence of BBB is 5.9% in Gao-hang community of Shanghai. There was significant correlation between LBBB and cardiovascular risk factors, while RBBB was not associated with cardiovascular risk factors.

关 键 词：老年 束支传导阻滞 患病率 危险因素 

分 类 号：R541.76[医药卫生—心血管疾病]