电子对抗作业环境长期暴露对心脏自主神经功能指标的影响  

Effects of long-term operating exposed to electronic countermeasures environment on indexes of cardiac autonomic nervous function

作　　者：邱雅[1] 王子乾 耿淼[1] 王观筠 吴阳勋 张仕钊 陈红艳[1] 吕超[1] 贾建军[1] 姚树林[2] 尹彤[1] QIU Ya;WANG Ziqian;GENG Miao;WANG Guanyun;WU Yangxun;ZHANG Shizhao;CHEN Hongyan;LYU Chao;JIA Jianjun;YAO Shulin;YIN Tong(Institute of Geriatrics,Beijing Key Laboratory of Aging and Geriatrics,National Clinical Research Center for Geriatrics Diseases,the Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China;The First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第二医学中心老年医学研究所,国家老年疾病临床医学研究中心,衰老及相关疾病研究北京市重点实验室,北京100853 [2]解放军总医院第一医学中心核医学科,北京100853

出　　处：《解放军医学院学报》2022年第6期705-710,共6页Academic Journal of Chinese PLA Medical School

基　　金：军队后勤科研计划重点项目(BWS17J026);国家老年疾病临床医学研究中心开放课题(NCRCG-PLAGH-2022015)。

摘　　要：背景既往证据表明电磁辐射对心血管系统具有损伤作用,然而长期暴露于电子对抗(electronic countermeasure,ECM)电磁环境对心脏自主神经系统(cardiac autonomic nerve system,CANS)的影响研究甚少。目的探讨高频电磁环境长期暴露对电子对抗作业人员CANS功能指标的影响。方法2019年4-10月招募某电子对抗部队官兵,采用倾向性评分匹配方法均衡混杂因素,入选456例。根据作业环境分为暴露组[年龄(32.08±9.44)岁]和非暴露组[年龄(31.59±9.45)岁],两组各228例,其中男性均为214例,女性均为14例。入选者均行24 h动态心电图和24 h动态血压监测,比较两组心率、心率变异性(heart rate variability,HRV)、昼夜血压等心脏自主神经功能指标。结果电磁环境频段为5.5 MHz~1.84 GHz,介于高频至特高频。暴露组与非暴露组的年龄、性别、体质量指数、吸烟史和饮酒史差异无统计学意义(P>0.05)。24 h动态心电图可见暴露组干扰心搏数[Md(IQR):18643.00(8006.00,53010.75)vs 8006.00(8006.00,21826.75)]和窦性心动过缓阵数[Md(IQR):12.50(0.00,209.25)vs 0.00(0.00,9.00)]较非暴露组升高(P均<0.001),但最低心率较非暴露组显著降低[(43.39±5.15)/min vs(44.68±4.44)/min,P=0.004]。HRV指标中,反映迷走神经活性的全程相邻心搏间期差值均方根值(52.64±23.95 vs 48.28±18.58)和反映交感神经活性的极低频功率[Md(IQR):4650.92(3094.00,5519.50)ms^(2)vs 4650.92(3235.50,4650.92)ms^(2)]与非暴露组比较均显著升高(P<0.05)。此外,暴露组全天收缩压平均值[(117.46±6.70)mmHg vs(118.73±6.61)mmHg](1 mmHg=0.133 kPa)、全天舒张压平均值[(69.25±5.62)mmHgvs(70.76±5.68)mmHg]、白天舒张压平均值[(71.22±5.72)mmHg vs(72.70±5.69)mmHg],夜间舒张压平均值[(62.22±6.98)mmHg vs(63.54±6.06)mmHg]和夜间舒张压下降率较非暴露组均显著下降(P均<0.05),且暴露组反杓型血压[11(4.82%)vs 2(0.88%)]比例较非暴露组升高(P<0.05)。结论长期暴露于高频电�Background Previous evidences indicate that electromagnetic radiation may damage the cardiovascular system.However,there are few studies on the effects of long-term exposure to electronic countermeasures(ECM)electromagnetic environment on cardiac autonomic nerve system(CANS).Objective To investigate the effects of long-term exposure to high frequency electromagnetic environment on indicators of CANS of electronic countermeasure operators.Methods From April to October in 2019,officers and soldiers of an electronic countermeasures force were recruited,and 456 cases were assessed with propensity score matching method to balance confounding factors.The subjects were divided into the exposed group(age:32.08±9.44 years)and the non-exposed group(age:31.59±9.45 years)according to the operating environment,with 228 cases in each group,including 214 males and 14 females.The 24 h ambulatory electrocardiogram and 24 h ambulatory blood pressure were monitored in all subjects to compare the differences in heart rate,heart rate variability(HRV),and circadian blood pressure between the two groups.Results The electromagnetic environment frequency band was 5.5 MHz to 1.84 GHz,ranging from high frequency to ultra-high frequency.No significant difference was found in age,gender,body mass index(BMI),smoking history and drinking history between the exposed group and the non-exposed group.The 24 h dynamic electrocardiogram showed that the number of disturbed heart beats(Md[IQR]:18643.00[8006.00,53010.75]vs 8006.00[8006.00,21826.75])and sinus bradycardia(Md[IQR]:12.5[0.00,209.25]vs 0.00[0.00,9.00])in the exposed group were higher than those in the non-exposed group(P<0.001,respectively).However,the minimum heart rate was significantly lower than that of the non-exposed group([43.39±5.15]/min vs[44.68±4.44]/min,P=0.004).HRV indexes indicated that the square root of the mean squared difference of successive normal RR intervals(RMSSD)(52.64±23.95 vs 48.28±18.58)reflecting vagal nerve activity and VLF(4650.92[3094.00,5519.50]ms^(2)vs

关 键 词：电子对抗 高频电磁环境 心脏自主神经系统 24H动态心电图 24H动态血压 

分 类 号：R82[医药卫生—临床医学]