普通人群中室性早搏对全因死亡的预测意义
发布时间：2018-09-03 10:48
【摘要】：背景:普通人群中室性早搏(室早)的预后存在一定的争议。过去认为室早大部分是良性的,但近来一些研究表明室早会影响心脏功能以及生存预后。目前在中国的普通人群中,室早与全因死亡之间的关系尚不清楚。本研究通过初步横断面分析观察室早在人群中的患病率和危险因素,并通过随访观察发病率、预测因素及室早与全因死亡之间的关系。方法:在参加本队列研究初次体检的人群中,排除心电图诊断缺失以及首次心电图诊断为预激综合征及心房颤动、心房扑动的对象后共纳入99594名研究对象。以后每2年随访一次,观察患者是否出现新发的室早,同时通过及时调取医保中心及医院病历档案对终点事件全因死亡进行确认观察。结果:本队列中室早的患病率为1.1%,发病率为2.69/千人年。根据年龄和性别将研究样本分为6组。在第一个年龄段(18-35岁)中男女发患率无统计学差异。但在第二和第三个年龄组中男女患病率则存在明显差异(35-55岁:0.65%vs.0.84%,p=0.029;大于 55 岁:1.88%vs1.38%,p=0.009)。在 55 岁以下人群,女性的发病率并不低于甚至高于男性。但在55岁以上人群男性的发病率则明显高于女性。室早患病的危险因素为年龄、高血压、空腹血糖升高及高尿酸血症,新发的预测因素为年龄、男性、高血压及空腹血糖升高。本队列中未患室早的死亡率为7.72/千人年,而患室早的则为20.60/千人年。多因素校正的Cox回归分析结果提示,本队列中患有室早者较不患室早者死亡风险升高约 30%以上(HR=1.35,95%CI:1.15-1.58,P0.001)。结论:本队列研究发现,室早患病及发病与年龄相关,随着年龄的升高室早的发病率明显升高,尤其是在65岁及以上的中老年人群中。在55岁以下人群女性的发病率并不低于甚至高于男性。但在55岁以上人群男性的发病率则明显高于女性。经过平均7.82年的随访研究,发现室早会增加全因死亡风险。
[Abstract]:Background: the prognosis of ventricular premature beats in the general population is controversial. Ventricular premature disease has been thought to be mostly benign, but recent studies have shown that it affects heart function and survival outcomes. The relationship between ventricular premature and all-cause death is unclear among the general population in China. In this study, the prevalence and risk factors were analyzed by preliminary cross-sectional analysis, and the incidence, predictive factors and the relationship between ventricular premature and all-cause death were observed by follow-up. Methods: in this cohort, 99594 subjects were included in the study after exclusion of the absence of electrocardiogram diagnosis and the diagnosis of preexcitation syndrome and atrial fibrillation by the first electrocardiogram. The patients were followed up every 2 years to observe whether the patients had new room morning or not. At the same time, the terminal events were confirmed and observed by the medical insurance center and the hospital medical records. Results: in this cohort, the prevalence rate of ventricular premature was 1.1 and the incidence rate was 2.69 / 1000 person-year. The study samples were divided into six groups according to age and sex. In the first age group (18-35 years), there was no significant difference in the incidence of hair between men and women. But in the second and third age groups, the prevalence rate of male and female was significantly different (35-55 years old: 0.65, vs.0.84, p0.029; > 55 years old, 1.88 vs 1.38, P 0.009). In people under 55 years of age, the incidence among women is no lower or even higher than that of men. However, the incidence rate of males was significantly higher than that of females in the population over 55 years of age. The risk factors of ventricular premature disease were age, hypertension, high fasting blood glucose and hyperuricemia. The new predictors were age, male, hypertension and elevated fasting blood glucose. In this cohort, the mortality rate was 7.72 / 1000 and 20.60 / 1000, respectively. The multivariate adjusted Cox regression analysis showed that the risk of death was increased by more than 30% (HR=1.35,95%CI:1.15-1.58,P0.001) in this cohort. Conclusion: in this cohort study, the incidence of ventricular premature disease is associated with age, and the incidence of ventricular premature disease increases with age, especially in the middle-aged and elderly aged 65 years and over. The incidence among women under 55 years of age is no lower than or even higher than that of men. However, the incidence rate of males was significantly higher than that of females in the population over 55 years of age. After an average follow-up study of 7.82 years, it was found that early ventricular involvement increased the risk of all-cause death.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.7
，
本文编号：2219764
[Abstract]:Background: the prognosis of ventricular premature beats in the general population is controversial. Ventricular premature disease has been thought to be mostly benign, but recent studies have shown that it affects heart function and survival outcomes. The relationship between ventricular premature and all-cause death is unclear among the general population in China. In this study, the prevalence and risk factors were analyzed by preliminary cross-sectional analysis, and the incidence, predictive factors and the relationship between ventricular premature and all-cause death were observed by follow-up. Methods: in this cohort, 99594 subjects were included in the study after exclusion of the absence of electrocardiogram diagnosis and the diagnosis of preexcitation syndrome and atrial fibrillation by the first electrocardiogram. The patients were followed up every 2 years to observe whether the patients had new room morning or not. At the same time, the terminal events were confirmed and observed by the medical insurance center and the hospital medical records. Results: in this cohort, the prevalence rate of ventricular premature was 1.1 and the incidence rate was 2.69 / 1000 person-year. The study samples were divided into six groups according to age and sex. In the first age group (18-35 years), there was no significant difference in the incidence of hair between men and women. But in the second and third age groups, the prevalence rate of male and female was significantly different (35-55 years old: 0.65, vs.0.84, p0.029; > 55 years old, 1.88 vs 1.38, P 0.009). In people under 55 years of age, the incidence among women is no lower or even higher than that of men. However, the incidence rate of males was significantly higher than that of females in the population over 55 years of age. The risk factors of ventricular premature disease were age, hypertension, high fasting blood glucose and hyperuricemia. The new predictors were age, male, hypertension and elevated fasting blood glucose. In this cohort, the mortality rate was 7.72 / 1000 and 20.60 / 1000, respectively. The multivariate adjusted Cox regression analysis showed that the risk of death was increased by more than 30% (HR=1.35,95%CI:1.15-1.58,P0.001) in this cohort. Conclusion: in this cohort study, the incidence of ventricular premature disease is associated with age, and the incidence of ventricular premature disease increases with age, especially in the middle-aged and elderly aged 65 years and over. The incidence among women under 55 years of age is no lower than or even higher than that of men. However, the incidence rate of males was significantly higher than that of females in the population over 55 years of age. After an average follow-up study of 7.82 years, it was found that early ventricular involvement increased the risk of all-cause death.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.7
，
本文编号：2219764
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