金昌队列职业人群心律失常发病危险因素巢式病例对照研究  

Influencing factors of arrhythmia in a cohort of metal-expose workers(Jinchang Cohort): a nested case-control study

作　　者：张蕾洁 李娟生[1] 蒲宏全[2] 白亚娜[1] 李海燕[2] 程宁[3] 王琪 朱莞琪 袁艳 ZHANG Lei-jie;LI Juan-sheng;PU Hong-quan(Department of Epidemiology and Biostatistics,School of Public Health,Lanzhou University,Lanzhou,Gansu Province 730000,China;不详)

机构地区：[1]兰州大学公共卫生学院流行病与卫生统计学研究所,甘肃兰州730000 [2]金川集团股份有限公司职工医院 [3]兰州大学基础医学院

出　　处：《中国公共卫生》2020年第7期1036-1039,共4页Chinese Journal of Public Health

基　　金：国家重大公共卫生服务项目(财社[2012]64号);金川集团股份有限公司科学技术项目(JKZ20120013)。

摘　　要：目的了解金昌队列职业人群心律失常发病危险因素,为心律失常病因学研究及防治提供参考依据。方法采用巢式病例对照研究方法,于2011年6月—2013年12月在金昌队列职业人群中按年龄分层抽样获得5758名研究对象,随访2年后将随访期内459例新发心律失常者和3090名心电图正常者分别作为病例组和对照组,应用多因素非条件logistic回归模型分析金昌队列职业人群心律失常的主要危险因素。结果金昌队列病例组心率失常患者收缩压>140 mm Hg、有高血压家族史、肌酸激酶偏高和尿酸偏高的比例分别为18.30%、45.32%、8.06%和18.30%,均高于对照组心电图正常人群的13.37%、40.13%、5.66%和13.69%,差异均有统计学意义(均P<0.05)。多因素非条件logistic回归分析结果显示,年龄<45岁和≥65岁、有高血压家族史、尿酸偏高是金昌队列职业人群心律失常发病的危险因素。结论年龄较高或较低、有高血压家族史和尿酸较高的金昌队列职业人群更易发生心律失常。Objective To explore influencing factors of arrhythmia among metal-exposed workers in a cohort of Jinchuan Nonferrous Metals Corporation(Jinchang Cohort)in Gansu province of China and to provide evidences for developing etiology study and preventive measures for arrhythmia.Methods We selected 5758 workers by age stratification sampling from the participants of the Jinchang Cohort recruited from June 2011 to December 2013 and then conducted a 2-year followup among the workers.At the end of the follow-up,we assigned the workers with complete information into a case group(459 with first diagnosed arrhythmia)and a control group(3090 with normal electrocardiograph[ECG])for a nested casecontrol study.Multivariate unconditional logistic regression was used to explore influencing factors of arrhythmia among the workers.Results Compared to those among the controls,significantly higher proportions of systolic blood pressure>140 mm Hg(18.30%vs.13.37%),with family history of hypertension(45.32%vs.40.13%),with higher serum creatine kinase(8.06%vs.5.66%),with higher serum uric acid(18.30%vs.13.69%)were observed among the cases(all P<0.05).Multivariate unconditional logistic regression analysis revealed that aged<45 years,aged≥65 years,high serum uric acid,and family history of hypertension were risk factors for arrhythmia in the workers.Conclusion Arrhythmia is more likely to occur among the individuals with family history of hypertension and having higher serum uric acid among workers of all ages in the Jinchang Cohort.

关 键 词：心律失常 发病 金昌队列职业人群 危险因素 巢式病例对照研究 

分 类 号：R541.7[医药卫生—心血管疾病]