人类免疫缺陷病毒/艾滋病患者心电图特征和异常率分析  

Characteristics and abnormal rate of electrocardiogram in patients with human immunodeficiency virus/acquired immunodeficiency syndrome

作　　者：何小清 沈银忠 陆凤茹 沈芳 刘惜年 王树文 He Xiaoqing;Shen Yinzhong;Lu Fengru;Shen Fang;Liu Xinian;Wang Shuwen(Department of Infection and Immunity,Shanghai Public Health Clinical Center,Fudan University,Shanghai 201508,China;Department of Functional Examination,Shanghai Public Health Clinical Center,Fudan University,Shanghai 201508,China;Department of Medical Examination Center,Shanghai Public Health Clinical Center,Fudan University,Shanghai 201508,China)

机构地区：[1]复旦大学附属公共卫生临床中心感染与免疫科,上海201508 [2]复旦大学附属公共卫生临床中心功能检查科,上海201508 [3]复旦大学附属公共卫生临床中心健康管理中心,上海201508

出　　处：《中华传染病杂志》2019年第12期748-753,共6页Chinese Journal of Infectious Diseases

基　　金：国家"十三五"传染病重大专项(2017ZX10202101);上海市科委医学引导类科技支撑项目(17411969600);中国博士后科学基金项目(2014M560869)。

摘　　要：目的分析人类免疫缺陷病毒/艾滋病(human immunodeficiency virus/acquired immunodeficiency syndrome,HIV/AIDS)患者的心电图特征和心电图出现异常的情况,为HIV/AIDS患者心血管疾病的防治提供参考。方法收集上海复旦大学附属公共卫生临床中心的1131例HIV/AIDS患者和5622名HIV阴性体检者的心电图资料,比较2组人群的心电图异常率和异常类型分布。检测HIV/AIDS患者的CD4+T淋巴细胞计数、CD8+T淋巴细胞计数和CD4/CD8比值。组间比较采用χ2检验,logistic回归分析心电图异常率的影响因素。结果1131例HIV/AIDS患者中,心电图异常者611例(54.02%),常见的心电图异常为窦性心动过速239例(39.12%)、窦性心律伴ST-T段改变115例(18.82%)和窦性心动过缓55例(9.00%)。5622名体检者中,心电图异常者1958例(34.83%),常见心电图异常为窦性心动过缓633例(32.33%)、窦性心律伴ST-T段改变463例(23.65%)和窦性心律不齐256例(13.07%)。HIV/AIDS患者的心电图异常率明显高于体检者(χ2=140.39,P<0.01)。年龄<50岁和≥50岁的HIV/AIDS患者心电图异常率均高于对应年龄组的体检者,差异均有统计学意义(χ2=111.92、52.12,均P<0.01)。logistic回归分析显示,HIV感染者相对于HIV阴性者出现心电图异常的风险增加[比值比(odds ratio,OR)=2.27,95%CI 2.00~2.60,P<0.01];年龄≥50岁时,发生心电图异常的风险增加(OR=1.60,95%CI 1.45~1.77,P<0.01)。在HIV/AIDS患者中,不同水平的CD4+T淋巴细胞计数、CD8+T淋巴细胞计数和CD4/CD8比值的HIV/AIDS患者,心电图异常分布类型之间差异均有统计学意义(χ2=12.92、10.99、16.48,均P<0.05)。年龄≥50岁的HIV/AIDS患者发生心电图异常的风险增加(OR=1.50,95%CI1.15~1.96,P<0.01);CD8+T淋巴细胞计数≥500/μL时,HIV/AIDS患者心电图发生异常的风险降低(OR=0.75,95%CI 0.58~0.96,P<0.01)。结论HIV/AIDS患者心电图异常率高,以窦性心动过速和窦性心律伴ST-T段改变多见,年龄≥50岁的HIV/AIDS患者心�Objective To analyze the characteristics and abnormalities of electrocardiograms(ECG)in patients with human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS),and to provide evidences for the prevention and treatment of cardiovascular diseases in HIV/AIDS patients.Methods The ECG results of 1131 HIV/AIDS patients and 5622 non-HIV/AIDS subjects from Shanghai Public Health Clinical Center were involved.The abnormality rates and characteristics of ECG were compared between the two groups.CD4+T lymphocyte counts,CD8+T lymphocyte counts and CD4/CD8 ratios were measured in HIV/AIDS patients.The comparison between two groups was conducted by chi-square test.Logistic regression model was used to explore the factors associated with ECG abnormalities in HIV/AIDS patients.Results There were 611 cases(54.02%)out of 1131 HIV/AIDS patients with abnormal ECG.The common abnormal ECG types were sinus tachycardia 239 cases(39.12%),sinus rhythm with ST-T changes 115 cases(18.82%)and sinus bradycardia 55 cases(9.00%).There were 1958 cases(34.83%)out of 5622 cases of non-HIV/AIDS subjects with abnormal ECG.The common ECG abnormality types were sinus bradycardia 633 cases(32.33%),sinus rhythm with ST-T changes 463 cases(23.65%)and sinus arrhythmia 256 cases(13.07%).The abnormal rate of ECG in HIV/AIDS patients was significantly higher than that in non-HIV/AIDS subjects(χ2=140.39,P<0.01).The abnormal rates of ECG in HIV/AIDS patients<50 years old and≥50 years old were both higher than those of non-HIV/AIDS subjects in the corresponding age group,and the differences were statistically significant(χ2=111.92 and 52.12,respectively,both P<0.01).Logistic regression analysis showed an increased risk of abnormal ECG in HIV-infected individuals compared with non-HIV/AIDS individuals(odds ratio(OR)=2.27,95%confidence interval(CI)2.00-2.60,P<0.01).The risk of ECG abnormality increased in patients aged≥50 years(OR=1.60,95%CI 1.45-1.77,P<0.01).The ECG abnormal distribution patterns were significantly different between differ

关 键 词：心电描记术 人类免疫缺陷病毒 艾滋病 影响因素 CD4淋巴细胞计数 CD8淋巴细胞计数 

分 类 号：R51[医药卫生—内科学]