中国农村高血压人群心电图非特异性ST-T改变的流行病学调查

发布时间：2018-10-12 13:17

【摘要】：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(P0.05)。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P0.05);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,P0.05)。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。
[Abstract]:Objective to summarize the epidemiological characteristics and related factors of electrocardiogram (ECG) nonspecific ST-T changes in hypertensive population in rural China. Methods from May 19, 2008 to August 24, 2013, a total of 20 702 hypertensive patients aged 45 to 75 years from 32 communities in Jiangsu Province and Anhui Province were enrolled in the (CSPPT), study. Body mass index (BMI),) and blood lipid were measured to record the combined use of antihypertensive drugs and 12-lead electrocardiogram (ECG). The electrocardiogram was analyzed by Minnesota coding method. A total of 15 038 patients were enrolled to analyze the incidence of nonspecific ST-T changes. The patients were divided into normal ST-T group and ST-T change group according to electrocardiogram. The relationship between age, fasting blood glucose, smoking, alcohol consumption and nonspecific ST-T was analyzed. Results the incidence of non-specific ST-T changes in hypertension population in rural China was 8.5, among which 5.7in males and 10.3in females, and higher in females than in males (P0.05). Logistics regression analysis showed that: female (OR=2.07,95%CI1.68~2.54), elderly (55-65 years old OR=1.28,95%CI1.10~1.49;65~75), high systolic blood pressure (160-180 mm Hg). Hypercholesterolemia (OR=1.14,95%CI 1.01 ~ 1.29) and oral diuretics (OR=1.69,95%CI1.20~2.37) were the risk factors of nonspecific ST-T changes (P0.05), while oral angiotensin converting enzyme inhibitor (ACEI) was the protective factor of nonspecific ST-T (OR=0.68,95%CI0.54~0.86,P0.05). Conclusion the changes of electrocardiogram nonspecific ST-T are more common in rural hypertensive population in China, the overall incidence is 8.5. The risk factors are female, elderly, hypersystolic blood pressure, hypercholesterolemia and oral diuretics. The protective factors are oral ACEI..
【作者单位】：南昌大学第二附属医院心血管内科;上海交通大学附属新华医院心血管内科;北京大学第一医院心血管内科;国家临床肾脏病中心广州南方医院肾内科;
【分类号】：R544.1

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