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目的总结中国农村高血压人群心电图非特异性ST-T改变的流行病学特点及相关影响因素。方法数据来源于中国脑卒中一级预防研究(CSPPT),于2008年5月19日至2013年8月24日共纳入20 702例来自江苏省及安徽省32个社区中年龄45~75岁的高血压患者,行血压、脉率、体质量指数(BMI)、血脂等测定,记录合并使用降压药物情况,同时行十二导联心电图。心电图采用明尼苏达编码的方法进行分析。最终入组15 038例患者,分析统计总体及不同性别非特异性ST-T改变的发生率。并根据心电图分为ST-T正常组和ST-T改变组,分析年龄、空腹血糖、吸烟、饮酒等危险因素与非特异性ST-T改变的关系。结果中国农村高血压人群心电图非特异性ST-T改变的发生率为8.5%,其中男性为5.7%,女性为10.3%,女性高于男性(P<0.05)。Logistics回归分析显示:女性(OR=2.07,95%CI1.68~2.54)、高龄(55~<65岁组OR=1.28,95%CI1.10~1.49;65~75岁组OR=1.64,95%CI1.39~1.93)、高收缩压(160~<180 mm Hg组OR=1.62,95%CI 1.18~2.24;≥180 mm Hg组OR=2.20,95%CI 1.59~3.04)、高胆固醇血症(OR=1.14,95%CI 1.01~1.29)及口服利尿剂(OR=1.69,95%CI1.20~2.37)是非特异性ST-T改变发生的危险因素(均P<0.05);而口服血管紧张素转换酶抑制剂(ACEI)为非特异性ST-T改变发生的保护因素(OR=0.68,95%CI0.54~0.86,P<0.05)。结论在中国农村高血压人群中,心电图非特异性ST-T改变较常见,总体发生率为8.5%,其危险因素为女性、高龄、高收缩压、高胆固醇血症及口服利尿剂,其保护因素为口服ACEI。
Objective To summarize the epidemiological characteristics and related factors of non-specific ST-T changes of electrocardiogram in rural hypertensive population in China. Methods Data were from the Chinese Primary Prevention Study on Stroke (CSPPT). From May 19, 2008 to August 24, 2013, a total of 20 702 cases of age 45-75 years from 32 communities in Jiangsu Province and Anhui Province Patients with hypertension, blood pressure, pulse rate, body mass index (BMI), lipids and other measurements, recording the use of antihypertensive drugs combined with simultaneous 12-lead ECG. ECG analysis using Minnesota coding method. Finally, a total of 15 038 patients were enrolled, and the incidence of nonspecific ST-T changes in the overall population and gender was analyzed. According to the electrocardiogram, the patients were divided into ST-T normal group and ST-T change group, and the relationship between risk factors such as age, fasting blood glucose, smoking, drinking and nonspecific ST-T changes was analyzed. Results The prevalence of nonspecific ST-T changes in rural hypertensive population was 8.5% in China, 5.7% for males and 10.3% for females, and higher in females than in males (P <0.05). Logistics regression analysis showed that the odds ratio (OR = 2.07, 95% CI 1.68-2.54), advanced age (OR = 1.28,95% CI 1.10 ~ 1.49 in 55 ~ <65 years old group, OR = 1.64,95 % CI 1.39 to 1.93), high systolic blood pressure (OR = 1.62, 95% CI 1.18-2.24 in 160 ~ <180 mm Hg group, OR = 2.20, 95% CI 1.59-3.04 in ≥ 180 mm Hg group), hypercholesterolemia (OR = 1.14, 95% CI 1.01-1.29) and oral diuretics (OR = 1.69, 95% CI 1.20-2.37) were risk factors for non-specific ST-T changes (all P <0.05) Angiotensin converting enzyme inhibitor (ACEI) was a protective factor of nonspecific ST-T changes (OR = 0.68,95% CI0.54-0.86, P <0.05). CONCLUSIONS: Non-specific ST-T changes of ECG are common in rural hypertensive population in China. The overall incidence rate is 8.5%. The risk factors are female, advanced age, high systolic blood pressure, hypercholesterolemia and oral diuretics. The protective factors For oral ACEI.